Résumé :
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The theme of this issue is the decentralization of management responsibility in health care, in response to a politically derived imperative to control costs. (éditorial). Health policy everywhere is in flux. In marked contrast with the impenetrable orthodoxy and inaction characteristic of past decades, health policy currently is in the midst of large-scale upheaval. Many of the fundamental assumptions and principles that long guided health-sector development are in the process of being turned upside down. Whether a country is rich or poor, it matters not. Virtually every country either has or is contemplating major reforms in its provisions for the organization and financing of health services. Moreover, the differences in health services structure which divided nations, are becoming smaller - to the point where formerly shunned international exchanges now are considered useful mediums for the exposition of common tensions and the exploration of choices for adapting health care to complex and new economic realities. (R.A.).
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