the main nationals and regionals indicators studied in the previous sections per country are now showed as a comparison of regions.
Figure 35 Comparison between Antofagasta-Chile and Innsbruck (Tirol)-Austria. Author's Illustration based on the data used in this document.
It is clear to see that there are huge differences between both regions, that follows the current gap that a developing country may exhibit at being compared with a developed country. Even when Chile is one of the most solid economies in Latin America it is possible to conclude that the generational differences of the health care system is huge, this includes large differences in the preparation and availability of human resources to provide proper health care services. Altogether, the hospitals act in both regions as place builder organizations providing economical and social benefits to their inhabitants. Consequently, it is feasible to declare that both regions are better of by having their respective hospital installed within their area.
Antofagasta Innsbruck
Management of public Hospital - Private concession for 30 semesters (2017-2032)
Operated by Tirol Kliniken GmbH since 2015, owned by the state
National Health Care system - Bismarckian model Bismarckian model
National Population Coverage % 94% 99.9%
National Health spending (per capita) USD based on
PPP 2.182 5.395
National Life expectancy years 80.2 81.7
Regional population # 607.534 (2019) 760.161 (2020)
Average salary (Regional) €/Month 880,5 2.339,8
Days-off due medical licence (Regional) 3,3 3,6
Unemployment (Regional) % 6,7 2,1
Total surface of the hospital m2 123.118 885.000
Available beds # 671 1.548
Doctors (Regional) populationper 1.000 1,2 5,9
Nurses (Regional)
per 1.000
population 1,8 15,8
Avg. Monthly expense - Students €/Month 669 933
Avg. Monthly expense - Health professionals €/Month 927 2.186
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Limitations
The limitation of this research includes global difficulties and constrains that narrow the options of possible investigative paths. First, the current pandemic situation regarding the impact of COVID-19 in health care systems, economies, and societies clearly represents the most important bias that affect this study and the general investigations performed during the last year. Even when the comparison of health-economic indicators per region-country were based on official data from 2019 or earlier, in order to diminish any possible bias, the indicators could already have been impacted partially or it might represent a poorer performance than the expected. This situation may also have impacted the answers of the surveyed people who might be having economical difficulties due the damaged economic realities of some countries.
Another very strong limitation, that had to be faced several times during this study, is restricted access to information related to the organizations studied in this thesis. As it was mentioned during the present document, the health organizations (hospitals) analysed are currently being operated for private holdings and therefore the access to detailed information is not possible for external researchers or students. Furthermore, some of the indicators had to be rebuild from raw information due the lack of rigor in official reports that does not follow a common pattern per month/year or that have not been updated in the official repository.
Finally, it is relevant to mention that the comparison between the health care and economic realities made in this thesis, involves two different realities in terms of resources, wealth, and development, while Austria is a developed country Chile holds a status of developing country. Hence, some indicators may be influenced by several other variables and will require large and complex model to measure their performance; and the differences stated during this research might be also influenced for socio-political or other reasons that are not covered in this study but remains opens for next research.
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Conclusions
Once the long path of this research is concluded, some final reflexions emerge naturally after the several comparisons and analysis of the regional and national realities. The ‘place builder’ theory allowed to carry out an objective and innovative analysis to understand part of the benefits that some organizations bring to the society, and how these organizations become key players for the socio-economy welfare of the place where they are located. The places where the hospitals are located receive direct and indirect social-economic benefits that are consequence of their network structure of these entities and how it interacts with primary and secondary stakeholders.
Regarding the distribution of expenses of the studied population, it is possible to say that for the students’ population the direct contribution to the local economy is very stable in both countries representing between 80%-85% of the total student expenses per month.
This also applies to the indirect contributions to the economy where the percentages of expenses are between 12%-16% with only a small portion of contributions that does not stay in the local economy representing only 3.3%-4%) of the total expenses. This is a very interesting outcome due the large difference between the net monthly spending between both student’s population, this is how Innsbruck’s students requires 140% (993 €/month) of the monthly spending of Antofagasta’s students (669 €/month). Consequently, it is possible to conclude that for this population the allocations of resources in direct or indirect economic activities will not depends on the total living cost of the place. Nevertheless, the total amount that the local economy will receive from these populations is closely related to the total average living cost.
As a second point, health care professionals show a different allocation of resources. For both regions, there is sharp increase in the indirect contributions to the local economy representing increases in the demand of services such as restaurants, more comfortable ways of transport, social and leisure activities. This is how the mentioned population shows;
values of 75% (693 €/month) for direct contributions, 20% (187 €/month) for indirect contributions and 5% (47 €/month) for contributions to external economies, in Antofagasta.
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While the values are 62,1% (1.358 €/month) for direct contributions, 35.2% (770 €/month) for indirect contributions and 2.7% (58 €/month) for contributions to external economies.
For the above-mentioned population, the purchasing power show similar differences between regions, Innsbruck’s health professionals spend in average 142% (2.186 €/month) of the monthly spending of Antofagasta’s health professional (669 €/month). Hence, the gap of purchasing power between countries is confirmed for both groups in around 40%-42%, the explanation of this trend is based basically in the middle-income country level that Chile holds, compared with the high-income country that is Austria. Despite this, the contribution of this group remains relevant due their spending is higher than the students and demands more activities not-directly linked to the hospital but that the town should develop in order to offer these services to the population.
The hospitals build a better place around the place where they are located, this is not merely referred to the already proved economic benefits that these organizations bring to the region. But it becomes evident when the different comparison criteria are jointly analysed, both regions show better indicators for unemployment and absenteeism boosting regional productivity of their worker. Therefore, is not coincidence that industries will be more attracted to invest and develop new business in places where the workers have fewer sick days or where they can recover quicker due the health services available in the region. This these consecutive and favourable events for industries, leads also to an increase in the dynamics of the economy, boosting the average salary of the population. Even though, Innsbruck region (Tirol) shows a slightly lower average salary the spending that were obtained through the survey, performed in this thesis, shows high level of expenses that represents higher purchasing power which at the end, also becomes a contribution to the society.
For the analysis of Chilean reality, it is necessary to re-dimension the investment plans in infrastructure available for the population, as well as develop decentralization policies for increase the training of new and more health professionals that can stay in the region. In
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general terms, the ‘place builder’ framework and the results proposed in this thesis can be used by policymakers at national, regional, and local levels to promote policies that boost the local offer of services, improve the conditions to this sector, and building trustworthy relationships between the hospitals, or any ‘place builder’ organizations, and their local population.
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