Staff costs impede the acquisition of inputs, leaving little money for maintenance, equipment, medicines, and other supplies. CAUSES the public institutions of the Venezuelan State are experiencing a profound crisis that involves a complex of factors. This crisis is characterized mainly by the following factors: to) the institutional and programmatic disarticulation. It is determined mainly by the absence of coordination between the different entities providers of health services. It is important to clarify that in Venezuela there are more than 50 institutions providing health services in the sector public, being the most important and aggravated by the crisis in the sector; the Ministry of health and Social Development (formerly Ministry of health and welfare), the Venezuelan Social Security Institute, the Insurance Institute and Social assistance of the Ministry of education and the Governor of the Federal District. (b) an inappropriate model of health care: the provision of services is based on organisational forms implemented in the 1950s, when he had his phase of the Ministry of health and Social welfare consolidation yet.
Then same thing happens with the Venezuelan Institute of the social insurance, fundamental entities in public health care. These styles of attention did not reach the necessary changes based on space-territorial, demographic, epidemiological, political and economic changes that have characterized the country in the last two decades. (c) inappropriate management system. The one which basically is distinguished by its excessive centralization, verticality and poor institutional and social participation in the decision-making process. (d) inadequate model of financing and financial management; that is evidenced by a fiscal crisis in the sector, in an irrational composition of spending, a detached historical budgetary formulation of the volume, the quality of services and the impact on health, also an anarchy in the generation of alternative sources of financing without a clarity about their possible equity or inequity. (e) lack of trained personnel to undertake the laborious task that corresponds to an administrator or clinical engineer.
Then same thing happens with the Venezuelan Institute of the social insurance, fundamental entities in public health care. These styles of attention did not reach the necessary changes based on space-territorial, demographic, epidemiological, political and economic changes that have characterized the country in the last two decades. (c) inappropriate management system. The one which basically is distinguished by its excessive centralization, verticality and poor institutional and social participation in the decision-making process. (d) inadequate model of financing and financial management; that is evidenced by a fiscal crisis in the sector, in an irrational composition of spending, a detached historical budgetary formulation of the volume, the quality of services and the impact on health, also an anarchy in the generation of alternative sources of financing without a clarity about their possible equity or inequity. (e) lack of trained personnel to undertake the laborious task that corresponds to an administrator or clinical engineer.
