  This note tries to study how hospital behaviors, with reference to
interhospital collaboration or competition, could be affected by hospital
financing systems. For that this note simulates two scenarios which start with
the following baseline scenario: a State, with a set of hospitals, each with
all types of wards at a basic level. The evolution of this baseline scenario
consists in the evolution of hospitals, that is, in the possibility of
hospitals to make some of their wards excel. The State has a budget, for the
evolution of this baseline scenario, which can be used by two financing
systems: either by a "local financing", i.e., by splitting the budget among the
hospitals so that each hospital is managing its own portion of the budget by
pursuing the individual benefit, or by a "central financing", i.e., by not
splitting the budget among the hospitals so that the State is the sole manager
of the budget, by pursuing the benefit of the whole community. The conclusions
seem to be that: in the local financing system hospitals tend to diversify
their excellences, while in the central financing system the State tends to
create poles of excellence.
