Coordination Through Contracting: Experience with the Estonian: out-of-hospital emergency medicine

Abstract

The article examines the effects of market-type contracting on the capacity of the government to integrate public service stakeholders and to assure coherence in service provision. The study focuses on the case of the Estonian out-of-hospital emergency medical care and analyses it through an analytical framework, concentrating on basic coordination mechanisms, coordination resources and their application in a specific policy field. It is found that effective market-based coordination presumes long-term learning and the use of various coordination resources that go beyond simple bargaining. In addition, contracting for service delivery has a significant influence on the capacity of the government to coordinate both policy-making and the interlinkages of different policies.