Abstract
BackgroundOutsourcing is a kind of participation between public and private sector. This should be monitored and supervised to enhance the quality of outsourced services and to prevent new problems in this area. Shiraz University of Medical Sciences (SUMS) hospitals increasingly use outsourcing in recent years.ObjectivesThe present research aimed at comparing outsourced departments of SUMS from economic view, accessibility of services, and service quality during the years 2010–2012.MethodsA before and after descriptive and analytical design was applied in outsourced departments of SUMS in 2014. First, 17 indicators were extracted by Delphi technique. Then, all outsourced units were assessed using economic, access to services, and quality indicators during 2010 to 2012.ResultsAfter outsourcing, in all pharmacies and dentistry units, except one, loss decreased and benefit increased from public sector viewpoint. The number of personnel for one pharmacy and two laboratories was decreased, while it remained unchanged for dentistry units. The total number of clients was increased for all pharmacies and laboratories and decreased for one dentistry unit. Patient satisfaction for pharmacies, laboratories, and dentistry units was 73.4%, 80.3%, and 78.5%, respectively. Also, employer’s satisfaction from contraction was 60%, 68%, and 93.3% for pharmacies, laboratories, and dentistry units, respectively.ConclusionOutsourcing as an effective strategy resulted in increase in the personnel, client, and stakeholder satisfaction. Also, it increased benefit and decreased cost for public sector. It is recommended that rules for the implementation of this strategy and monitoring the private sector should be defined.
Highlights
In recent decades, reform in health systems mainly focused on financing, resource allocation, service delivery, and equity
4 Results During 2010 to 2012, 13 medical units in Shiraz University of Medical Science were outsourced to private sector, among which, 67.9% were leased including 5 pharmacies, 1 dentistry, and 3 lab units; 15.4% were collaborative including 2 dentistry units and 1 physiotherapy units; and 7.7% were management type including 2 lab units (Table 1)
In terms of the employer satisfaction (Shiraz University of Medical Sciences) from the contractor, the results showed that the lowest grade belonged to Sede Eghlid dentistry unit, and in two other units, it was evaluated as perfect
Summary
Reform in health systems mainly focused on financing, resource allocation, service delivery, and equity. Reform in service delivery was performed via a policy named decentralization which mainly aimed at improving efficiency and responsiveness [1]. Outsourcing could merge private sector advantages—such as efficiency [1, 6] and consumer satisfaction [7, 8]—into the public sector and avoid its disadvantages—such as inattention to equity and social responsibility [9]. This could result in generating internal market or quasi-market in the public sector that promotes competition [10, 11]. Shiraz University of Medical Sciences (SUMS) hospitals increasingly use outsourcing in recent years
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