Self-Sustainability

The AHD Model champions financial self-sustainability. The key to financial success has been public – private partnerships with the local, regional, and national governments of Ecuador. Hospital PVM incurs no operating deficit.  It has achieved this through an innovative combination of financing mechanisms:

1. Payments on a services – rendered basis from the Social Security Administration (SSA) (60%)

2. Small fees for service from patients (35%)

3. Contributions from local municipalities (5%).

Fees range from $3 for an outpatient visit to $180 for a cesarean section. AHD uses the public funds more efficiently than does the public health sector, which leaves additional money to cover payments by indigent patients. Only with this model can everyone in the community, in spite of limited resources, count on quality medical services. No one is turned away, and the hospital operates with its own revenues. To learn more about the AHD Model, read Dr. Gaus’s article in the Global Health Council’s Health AffairsThe Rural Hospital in Ecuador.


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Andean Health & Development
UW Department of Family Medicine
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