Decentralization and Structure of Medical Salaries in Argentina: A Comparative Analysis in Five Jurisdictions

Abstract

INTRODUCTION: The functioning of the health system is based on the characteristics of the human resources and on how they coordinate and complement each other to cover the population’s needs. OBJECTIVES: To analyze the contractual characteristics of physician wages in Argentina as well as their amounts and composition, in the context of a decentralized public health system. METHODS: Case studies were performed in five jurisdictions in Argentina: Buenos Aires City, Chaco, La Rioja, Neuquén and Salta. In each of them, three public hospitals were selected. Multiple-choice surveys were conducted on a representative sample of medical personnel. Databases of medical wages were used as secondary source of information, they were provided by the Human Resources Department of each Ministry of Health. RESULTS: The capacity to define “game rules” relevant to contractual arrangements, wage levels and structure is extremely wide between jurisdictions and even between hospitals. The analysis showed a high level of formalization of labor contracts, diversity in management and incentive structures, and significant gaps between hospitals within each jurisdiction. CONCLUSIONS: The topic of medical remuneration in Argentina presents not only a wide variety of cases and peculiarities by jurisdiction, but also many alternative approaches.