Abstract
The research involves determination of the extent to which the public-private partnership model can contribute to the improvement and enhancement of the healthcare services in Macedonia. To achieve this purpose, the research embraces comprehension of the common advantages and disadvantages of this model, encompassed with a case study of the public-private partnership in the specialized-consultative health protection for the health activity-dialysis, together with other efforts to ensure high quality health protection. It also reflects the attitudes of the public authorities and private sector entities regarding the significance of the public-private partnership model, consideration of the advantages and disadvantages before entering public-private partnerships and the ways public-private partnerships affect the employees and employments.The study outlines planned and realised efforts to implement this model to ensure better and more efficient healthcare system.Generally, the results from the survey and the outlined case study present this model as good solution for many healthcare challenges, since public-private partnerships offer different services to the citizens that neither the public nor the private sector could separately achieve. The public-private partnership model leads to new employment opportunities according to the opinion of the public authorities, while the private sector entities consider that public-private partnerships increase the responsibility of the employees in such partnership in comparison to the public sector. The outlined case study is an example of successful public-private partnership model in the field of healthcare and can serve as motivation for further implementation of this model to ensure better, enhanced and modern health system.
Highlights
Concessions and public-private partnerships have often been the focus of many analysis, theories, discussions, and treated in many national legislations
Increased responsibility of the people employed in the public-private partnership compared to those of the public sector
None of the participants representing the first group considers that public-private partnerships produce an opportunity for additional employee trainings, but contrary to this, 2 or 11.76% of the participants representing the second group believe that the constitution of publicprivate partnership produces such opportunity
Summary
Concessions and public-private partnerships have often been the focus of many analysis, theories, discussions, and treated in many national legislations. There are several differences between the standard competitive and the medical markets, according to the following criteria: 1. Profit- Standard competitive markets maximise their profits, but many hospitals do not achieve profit; 3. 4. Customers’ payments-Customers’ direct payments are features of standard competitive markets, while the patients cover just a part of the expenses. Private hospitals are profit oriented, efficiency motivated and gained higher reputation than the state hospitals (Kekenovski 2010, pp.193198). Changes in population or increased number of older and urban population produce demand for expensive tertiary health care. Having in mind the increased expenses, there is a belief that publicprivate partnerships will produce efficient and improved health care services that will lead to relief from the increased costs. Other activities are required such as ensuring better risk sharing mechanisms, engagement of the governments in defining the structure of the health system, strategic planning for both of the partners to prosper from the partnership (Mitchell, n.d.)
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