PPP hospitals in Portugal: what does benchmarking tell us about their relative performance?

Abstract

After some significant reforms, four Public-Private Partnership (PPP) hospitals were established in Portugal. Despite their establishment, a choice was made in favor of the establishment of regular corporatized public hospitals. Comparing PPP hospitals and other publicly managed (corporatized) hospitals in terms of their performance is important. This study uses Portuguese hospitals' data (2015-2019) to compare both groups of hospitals in terms of efficiency, access, care appropriateness, and clinical safety, which are linked to the overall performance categories of cost and quality. The first results showed that PPP projects exhibited the best average performance. However, according to the Malmquist Index, although publicly managed hospitals presented the best productivity levels, they also had the highest performance spread. In short, the index suggests that PPP hospitals outperform the corporatized ones. One can draw the critical conclusion that PPP hospitals are not, in general, harmful projects for the public purse.