this system provides weak stimulus to continuous quality improvements in the provision of care since most professionals are paid solely through fixed salaries with no link to performance assessment and in many instances contracts are temporary and do not include social security benefits evidence from other national settings have concluded that movements away from salary mechanisms for health professionals are a successful strategy to raise allocative efficiency for example through the strengthening of the primary care system by improving user experience when remuneration is at least partly tied to performance as well as prevention of more expensive care including avoidable hospitalisations morenoserra providers tend to be largely concentrated in densely populated areas with a notable increase in the number of private providers in those localities in the last ten years