Money vs. access: efficiency in public and private health care

Abstract

Introduction: the quality of health care constitutes a central pillar of health systems, particularly in contexts marked by pronounced inequalities between public and private sectors.

Objective: to analyze the quality of medical care in Ecuador within public and private hospital sectors.

Methods: an exploratory bibliographic review was conducted. The search was carried out in recognized scientific and academic databases using terms related to quality of care, public health, and hospital services. Relevant sources were selected based on timeliness, thematic relevance, and academic rigor, complemented by an analysis of the current Ecuadorian legal framework.

Development: substantial differences exist between the care provided in public and private hospitals in the country. The public sector shows limitations associated with administrative deficiencies, shortages of supplies, inadequate infrastructure, and high service demand. In contrast, the private sector has greater technological and human resources, resulting in a better perceived quality of care, although with economic barriers to access. Furthermore, health legislation is identified as remaining insufficiently updated in relation to social and health-related changes.

Conclusions: there is a significant gap in the quality and effectiveness of care between public and private sectors in Ecuador, with direct implications for equity and population satisfaction. The evidence highlights the need for regulatory reforms, institutional strengthening, and optimization of public management to promote a more efficient, accessible health system aligned with the country’s current needs.