[Pay for performance in public directly managed healthcare centers. Part 1: General framework. SESPAS Report 2024].

Assessing and compensating performance in professional organizations is extremely difficult in direct public management settings of health services. Performance assessment is technically complex and, more so, with multiplicity of principals influencing goal setting. Incentives are a lever to generate directionality and motivation, both structural (for attracting and retaining workers) and specific ones (rewarding performance and directing behavior towards institutional goals).

[Pay for performance in public directly managed healthcare centers. Part 2: The Spanish National Health System. SESPAS Report 2024].

In Spain, the compensation model for statutory health personnel is complex, heterogeneous, and more oriented to rewarding complementary functions and activities, than to paying for the actual performance in the position of employee. The various attempts to incorporate incentives have been distorted by a civil service egalitarianist culture, and weak systemic governance. External attractors (private practice, etc.

[Contemporary relevance of the Spanish General Health Act after twenty five years].

Since its enactment in 1986, the General Health Law (Law 14/1986) has undergone several changes that have consolidated a model of National Health System. The law was embodied in 113 articles, ten Additional Provisions, five transitional arrangements, two Repeal and fifteen Final Provisions, has altogether 143 articles. After reviewing all legislation that appeared from 1986 to until today we can see that there are 106 articles (74.

[Identification and modulation of the systematic irrational behaviour in medicine and public health].

Several scientific disciplines are focused in the irrational behaviour of individuals. This predictably or systematic irrationality though violates the assumption of "maximising the expected utility", creates a new promising field of research and policy improvement. In this paper five dimensions in the distortion of preferences and decisions are reviewed, and some examples of policy initiatives for redressing and influencing the misled behaviour are provided.

[Asymmetric policies for merit-goods: harmonizing individual and social preferences in public health].

Behavior is a major determinant of health, but changes in individual conduct are difficult, and health promotion lacks effectiveness. State intervention in the last century, rooted in the modernist movement, went far beyond dealing with externalities and built the framework of the welfare state. The crisis of the welfare state and post modernity after the 1970s led to a weakness of ideologies and values, narcissistic individualism, and lack of trust in institutions, all of which hampered the ability of society's perspective to influence individual behavior.