The Public Procurement and the Quality of Services: The Case of Moscow Hospitals

Abstract

The work is devoted to the search for answers to the question: “Are there any differences in the public procurement of customers who provide services of different quality?”. The article identifies the stages of the hospital procurement process in the contract system and highlights the main customer strategies used in the auction. The results of an independent quality assessment are examined and comparative hospital characteristics with low and high quality rating are conducted. The hospital needs according to the types of purchases and their annual volumes of contracts are analyzed. The advantages of competitive procedures are determined and the key factors affecting the level of competition with possible risks of unreliable execution of contracts are identified. The empirical study is based on the database which includes 5390 contracts of 2 hospitals in Moscow for years of 2011–2017. Using the methods of econometric analysis, in particular, the method of least squares and the difference in the average, the hypothesis is tested the high competition has a positive effect on the quality of medical services. The constructed regression models show that the customer providing high quality services has low competition and small rebates at the auction. At the same time there are more contract terms, delays in the supply of goods and services as compared with the customer providing low quality services. Thus it was found that the underestimation of competition at the auction indicates the desire of the hospital to guarantee a higher quality of medical services to patients while as aggressive bids of participants lead to the supply of poor purchases. The results of the study may be useful for the competent authorities in the development of legal acts for the participants of the contract system in the field of health procurement.