Health services, like many other forms of production, can be implemented in more dispersed
or more concentrated configurations, or in hybrid arrangements that combine some
concentrated with some dispersed elements (41). Dispersed service configurations are usual
for activities which do not benefit from economies of scale – unit costs are no lower for
large than for small production units – such as primary care, including the integrated management
of childhood illness; pharmacies; dental offices; field-based implementation of
public health programmes; counselling; social work; and community and home-based care.
Such ambulatory services usually involve a fairly broad range of activities of varying degrees
of complexity, such as the management of common clinical and nonclinical activities
by individuals or small teams of people.