Public-Private Partnerships In Healthcare Research Articles

Teleradiology public-private partnerships in Saudi Arabia: a review

Owing to the increasing demand for healthcare driven by population growth, the Kingdom of Saudi Arabia’s (KSA) Ministry of Health (MOH) is actively seeking to improve the quality and efficiency of healthcare services in general and medical imaging services in particular by introducing private sector participation in its first healthcare public-private partnership (PPP) venture for teleradiology. Teleradiology will also benefit the more remote areas of the country that are currently underserved. Through the PPPs, hospitals in the project will have interconnected teleradiography services, ensuring efficiency and cost-effectiveness compared to the current public provision of medical imaging services. This review is based on secondary data collected from various computerized repositories, databases, or search engines encompassing articles, MOH documents, and reports in this regard. This review describes healthcare PPPs and how they will operate teleradiology in the KSA. We further highlight obstacles to the involvement of the private sector in the provision of public teleradiology services.

Making Knowledge Hereditary: Public–Private Partnership Drives Progress in Rare Disease Community

Background: Hemophilia is a rare and complex inherited bleeding disorder in which people may experience prolonged, painful, and debilitating bleeds due to an inability of their blood to clot properly. Although there has been great progress in the management of the disease over the past 50+ years, many important scientific questions have gone unanswered. Further, despite decades-long interest and desire by medical providers and scientists, the U.S. government and the hemophilia community to conduct comprehensive genetic testing to better understand the disorder, challenges such as cost, access, and privacy concerns served as ongoing obstacles. Focus of the Article: To overcome these challenges and address this unmet need, four community organizations and a health communications and social marketing agency came together in 2011 to create a first-of-its kind public–private partnership (PPP) called My Life, Our Future (MLOF) to provide people with hemophilia information about their disorder while also furthering scientific understanding. Importance to the Social Marketing Field: This article will explain how MLOF utilized social marketing to drive broad community engagement, ultimately genotyping more than one third of the U.S. male hemophilia population through the program and opening the MLOF Research Repository, the largest research repository of its kind. It will also discuss the key learnings gleaned through the establishment and implementation of this program, notably the strength of a PPP in health care.

Proactive and Strategic Healthcare Public-Private Partnerships (PPPs) in the Coronavirus (Covid-19) Epoch

Abstract: The coronavirus (COVID-19) pandemic has overwhelmed many national healthcare systems around the world. In attempts to meet their emergency needs and mitigate escalating challenges, governments are increasingly reaching out to the private sector to form sustainable, public-private partnerships (PPPs). Unfortunately, many of these ad hoc efforts have been reactive and uncoordinated to date. This perspective article thus offers a proactive, collaborative, and strategic vision for healthcare PPPs, focusing on short-, medium-, and long-term proposals that will harmonize strategic objectives and mobilize both public and private resources to combat and build resilience against global pandemics like COVID-19.

The public-private partnership in Russian health care: the regional aspect

The health care problems are considered in detail both in the program and non-program activities of the sector state regulatory bodies. The public-private partnership, in particular, participation of private clinics in the system of mandatory health insurance can become one of the effective tools to cope with many problems. The article analyzes participation of private clinics in implementing territorial program of mandatory health insurance as exemplified by the Krasnodar Krai. This is to provide guaranteed free medical care by private clinics of municipalities in the Krai. The regional features of public-private partnership in health care are considered in fairly prosperous Russian region that allow to develop positive scenario. Out of the total number of medical organizations, potential participants of the mandatory health insurance system the private clinics were identified. The analysis of participation of private medical organizations in the mandatory medical insurance system was carried out in context of two main classification criteria: geographical location and the type of medical services. According to the study results, the structure of private clinics of the Krasnodar Krai participating in mandatory health insurance program on a territorial basis is determined. The types of medical care that are not carried out by the selected companies, as well as the types of medical services that are in demand by private clinics are established. The list of private clinics participating in territorial mandatory health insurance program with the widest range of services is determined. The matrix of participation of private clinics in mandatory health insurance system was developed on the example of the Krasnodar Krai.

PPP in Health Care—Trending Toward a Light Model: Evidence From Italy

Italy, as many other countries, adopted the design–build–finance–maintain (DBFMO) Anglo-Saxon model to build new hospitals. This model proved to be rigid, nontransparent, nonvalue for money, and unaffordable. The aim of this article is to analyze the main drawbacks of the traditional DBFMO public–private partnerships (PPP) contract applied to the health care sector, by referring to the Italian experience, and to discuss the evolutions, conceived through an inductive/deductive approach, conducted in a context of deep collaboration between academia, health care authorities, and market players to make PPP contracts more value for money, flexible, and affordable. The article provides also an example of the role of academia in closing the rigor–practice gap by supporting and facilitating an institutional change.

Lessons from Healthcare PPP’s in India

The NITI Aayog is working to develop and conduct pilot public–private partnership (PPP) projects to improve the delivery of healthcare services. The last two decades saw a rise in discussions and debates on the varied PPP models, as an opportunity to harness the private sector efficiencies and to supplement the public resources. However, the enthusiasm for experimenting with the PPP models fall short of the learnings from it. The limited but growing evidence based on PPPs in healthcare suggests that even the basic tenets of design and implementation of the PPP model have not been met, such as selection of qualified providers\contractors, designing contracts that align incentives, appropriately allocate risks and managing contracts using appropriate performance management tools. In general, the PPP models involve considerable risks and more so in healthcare given its unique characteristics, therefore if not designed and implemented with care, PPP’s in healthcare would prove to be wasteful and burdensome on the public exchequer.

Biomedical Ethics and Human Rights in The Context of Innovation and Information Development of Society

The article is devoted to the issues of biomedical ethics and human rights in the conditions of innovation and information development of society. The factors of the emergence of modern biomedical ethics under the evolution of biology and medicine, including innovative technologies. Under "biomedical ethics," the branch of knowledge is considered, which is a system of ethical and legal norms that regulate relations in the field of biomedicine, a set of moral principles, norms and rules that medical professionals should observe in the course of professional activity. Sources of biomedical ethics are singled out: national legislation in the field of medicine; international medical law regulating legislation; international ethical (deontological) codes containing recommendations on medical ethics; national ethical (deontological) codes of professional ethics of medical staff. The basic functions of biomedical ethics are disclosed: informational, axiological (value), communicative, preventive. The issue of ratification by the Verkhovna Rada of Ukraine of international acts as a condition for ensuring the protection of human rights is explored. The expediency of adopting a special law "On the Protection of Patients’ Rights", which determines the legal, economic and organizational foundations for the protection of the rights and legitimate interests of patients, including biomedical ones, is substantiated. The need to overcome the gaps in the legislation of Ukraine by unifying and developing concepts in the field of biomedicine, the normative consolidation of ethical requirements for medical staff and the implementation of biomedical research and medical practice, as well as the responsibilities of patients, is emphasized. The emphasis placed on the need to improve the domestic health care model through the introduction of a public-private partnership in healthcare. The importance of creating a system of organizational and legal measures to improve control over the implementation of laws and regulations on the observance of the legality of processing personal data through the establishment of rules of legal responsibility, the provision of the use of electronic services in order to implement the rights of patients, the development of criteria-signs of the concept of "personal data". The prospect of further research on biomedical ethics and human rights through the improvement of legal theory and legal practice is determined. It is concluded that fundamental human rights should remain the basis for solving existing ethical and legal problems in the field of biomedicine.

PUBLIC-PRIVATE PARTNERSHIP AS AN INVESTMENT AND INNOVATION TOOL FOR MEDICAL FACILITIES: A CASE OF UKRAINIAN HEALTHCARE

This paper summarizes the scientific discussion on the issue of public-private partnership in healthcare sector. The main purpose of research is to analyze the public-private partnership as the progressive form of innovative and investment mechanism in Ukrainian healthcare sector, taking into the consideration international experience in this sphere. The key methods used in the conducted research are data analysis, summarization and comparison. The data synthesis and analysis are the basic value-added elements of this research, which could help to find out the main prospective of PPP-model use in Ukrainian healthcare sector. The object of research is the group of countries such as USA, UK, Canada, and BRIC countries, because namely they are the most progressive in public-private partnership in health care. Practical importance of the scientific research results lies in defining the general principles of public-private partnerships and a set of criterion for its efficiency estimation. Also, the worldwide experience was analyzed in this research and main challenges for its implementation in Ukrainian healthcare practice were considered. It is important for the further development of the healthcare sphere, and improvement of the healthcare facilities' activity in Ukraine. Further research directions are aimed at study of the specific issue of public-private partnership, such as circumstances for creating alliances between private and public actors from a strategy perspective, explore the impact of incentive mechanisms and risk management procedures on health service performance throughout the extended project life-cycle, and to create conducive environments to foster inter-project learning.

STATE-PRIVATE PARTNERSHIP − A MODEL FOR REFORMING UNIVERSITY CLINICS


 
 
 The aim of the work to substantiate the possibility of using public-private part- nership (PPP) as a tool for the innovative development of university clinics (UK).
 Results the article reveals the problems of the current system of university clinics, shows the foreign experience of using public-private partnerships in healthcare. PPP mechanism is defined as the main tool for reforming university clinics. The main directions of the devel- opment of the UK, such as: regulatory, organizational, managerial, financial, informational, capable of providing a modern, autonomous, economically sustainable model of the UK, is also presented in the article.
 Conclusions the article describes the current university clinics in Ukraine. Taking into account the experience of developed countries of the world, as well as the economic situation in Ukraine, a more effective form of organizing of UK on the principles of PPP as a tool for innovative development of university clinics is sustained.
 
 

Public-private partnership in health care - a tool for the development of public medical insitutions

Public-private partnership in health care - a tool for the development of public medical insitutions

Public-Private Partnership in Health Care and Its Impact on Health Outcomes: Evidence from Ruharo Mission Hospital in South Western Uganda

Background: Uganda’s government embraced private provision of social services including health care. The involvement of private providers is an indicator that the public facilities are not sufficient enough to meet the high demands of the ever-increasing population. This has been done through partnership arrangements. This paper discusses the impact of Public-Private Partnership (PPP) on health care outcomes of the local population and opportunities for improving health outcomes, challenges facing private providers in a low-income setting like Uganda. Methodology: This was a qualitative study, data were collected using qualitative methods in January 2017 through interview (using semi-structured questions) at Ruharo Mission Hospital (RMH) administration, health workers, district health office and used a structured questionnaire for patients/clients. This was a nascent study, with a sample size of 22 respondents. The hospital has three departments; Organized Useful Rehabilitation Services (OURS), General Medical Services (GMS) and Eye Department (ED). All the departments of the hospital were represented in this study. Results: The hospital is a Church of Uganda founded, and runs a budget of 5 billion shillings ($ 1,351,351.4) annually, has multiple sources of funding including PHC funding annually and that, health services were delivered adequately to clients. Much as some services were accessed at no costs, other services like eye treatment were found expensive on the side of clients. The hospital’s hybrid mode of delivering health services through outreaches and facility-based services was cherished, however it had no ambulance and relied only on a hospital van. Conclusions and Recommendations: Our study concludes that if private providers are supported under the partnership arrangement, they can adequately deliver services to the clients and decongest the public facilities. We recommend that the government devote more funds to support the hospital through employing more sub-seconded staff, procuring medicines, and ambulances to enable it to subsidize services especially eye treatment and other services not supported under the partnership.

An Ethics Framework for Big Data in Health and Research

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and Policy-relevant Ethics in Singapore (SHAPES) Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data.

Big Data and Public-Private Partnerships in Healthcare and Research

Public-private partnerships (PPPs) are established to specifically harness the potential of Big Data in healthcare and can include partners working across the data chain—producing health data, analysing data, using research results or creating value from data. This domain paper will illustrate the challenges that arise when partners from the public and private sector collaborate to share, analyse and use biomedical Big Data. We discuss three specific challenges for PPPs: working within the social licence, public antipathy to the commercialisation of public sector health data, and questions of ownership, both of the data and any resulting intellectual property or products. As a specific example we consider the case of the UK National Health Service (NHS) providing patient data to Google’s DeepMind AI program to develop a diagnostic app for kidney disease. This article is an application of the framework presented in this issue of ABR (Xafis et al. 2019). Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. We use four specific values to help analysis these issues: public benefit, stewardship, transparency and engagement. We demonstrate how the Deliberative Framework can support ethical governance of PPPs involving biomedical big data.

Классификация видов государственно-частного партнерства, используемых в здравоохранении

Классификация видов государственно-частного партнерства, используемых в здравоохранении

Public-Private Partnership in Health Care and Its Impact on Health Outcomes: Evidence from Ruharo Mission Hospital in Uganda

Background: Uganda’s government has embraced private provision of social services including health care. The involvement of private providers is an indicator that the public facilities are not sufficient enough to meet the high demands of the ever-increasing population. This has been done through partnership arrangements. This paper discusses the impact of Public-Private Partnership (PPP) in health care outcomes of the local population and opportunities for improving health outcomes, challenges facing private providers in a low income setting.Methodology: Data were collected using qualitative methods in January 2017 through interview (using semi-structured questions) at Ruharo Mission Hospital (RMH) administration, health workers, district health office and used a structured questionnaire for patients/clients. This was a nascent study, with a sample size of 22 respondents. The hospital has three departments; Organized Useful Rehabilitation Services (OURS), General Medical Services (GMS) and Eye Department (ED). All the departments of the hospital were represented in this study.Results: The hospital is a Church of Uganda project and runs a budget of 5 billion shillings ($ 1,351,351.4) annually, had multiple sources of funding including PHC funding annually and that, health services were delivered adequately to clients. Much as some services were accessed at no costs, other services like eye treatment were found expensive on the side of clients. The hospital’s hybrid mode of delivering health services through outreaches and facility-based services was cherished, however it had no ambulance and relied only on a hospital van.Conclusions and Recommendations: Our study concluded that if private providers are supported under the partnership arrangement, they can adequately deliver services to the clients and decongest the public facilities. We recommend that the government devote funds to support the hospital through employing more sub-seconded staff, procuring medicines, and ambulances to enable it to subsidize services especially eye treatment and other services not supported under the partnership.

Public-private partnership in health care of India: A review of governance and stewardship issues

Indian health care is characterized by a mixed health system and different kinds of delivery structure. Mixed health systems can be defined as involving ‘centrally planned government health services that operate side-by-side with private markets for similar or complementary products and services’.1 Public health care delivery system includes teaching hospitals, secondary level hospitals (at district and subdivisional level), first-level referral hospitals (community health centres/rural hospitals), dispensaries, primary health centres, sub-centres and health posts. The private sector, both for-profit and not for profit, however, is the dominant sector and services range from 2-bed facilities to 1000+ bed hospitals.2The private provisioning of health care has grown from a mere 5 to 10 percent during India’s independence era to 82 percent of outpatient visit, 52 percent of inpatient expenditure, and 40 percent of births in institution.3 A report of the task force on Medical Education for the National Rural Health Mission in India determined that the private sector provides 58 percent of hospital buildings, 29 percent hospital beds, and 81 percent of the doctors in India.

Increasing the Governance Standards of Public-Private Partnerships in Healthcare. Evidence from Italy

Healthcare systems have changed rapidly in the past few decades due to increasing healthcare costs and decreasing governmental budgets. The structural complexity, huge numbers of actors and long-term relationships inherent to PPPs bring out several governance issues. Based on the principles of good governance for PPPs published by the United Nations Economic Commission for Europe (UNECE) in 2008, we try to answer the following research question: How can the governance standards of PPPs be increased? This paper aims to explore issues of governance, management and policy design as they apply to PPPs in healthcare services. The evidence from a single case-study (the New Mestre Hospital) is presented and discussed. The main findings are that, despite its great success, the analysed PPP does have some governance problems that need to be addressed. Concluding remarks and insights for future research directions are then presented.

Entrepreneurs ' perspective on public-private partnership in health care and social services.

The purpose of this paper is to probe experiences of entrepreneurs in the social and health care service provision. Information was collected regarding entrepreneurs' views on the factors affecting the collaboration between public and private sectors. A sample of social and health care entrepreneurs was interviewed using open-ended questions. The interviews were transcribed and analysed using inductive content analysis. Three main categories of factors affecting the success of partnership were identified: the nature of partnership, business aspects and tension builders. Research LIMITATIONS/IMPLICATIONS: The research was undertaken in rural Finland and the sample consisted 13 entrepreneurs. The results must be considered as observations with more generalised conclusions. PRACTICAL implications - The results of this study support municipalities in their social and health care service strategy work and especially in consideration of how to also facilitate a fruitful public-private partnership (PPP)-framework, which will largely depend on mutual understanding and consensus. The reform of the social and health care system has raised intensive public debate throughout Europe. Key issues include the reorganising of social and health care processes as well as PPPs in provision of services. This study observes the views and experiences of private entrepreneurs and points out where some potential problems and solutions of social and health care PPPs are.

Public-Private Partnership in Health Care: A Comparative Cross-sectional Study of Perceived Quality of Care Among Parents of Children Admitted in Two Government District-hospitals, Southern India.

Perceived better quality of care draws lower socio-economic classes of Indians to more expensive private setups, leading to poverty illness poverty cycle. Urgent measures need to be taken to improve perceived quality of public hospitals. The present study compares the difference in perceived quality of care among parents of children admitted at two government district hospitals. A cross-sectional, comparative, questionnaire based study was conducted between February 2011 and February 2012 at Government medical college hospitals of two district headquarters in South-India: one with private-public-partnership (PPP-model); another directly operated by government - Public Hospital-model (PH-model). A total of 461 inpatients from the PH model hospital and 580 from the PPP model hospital were eligible. Patients who left against advice (LAMA) (n=44 in PH and 19 in PPP) and expired (n=25 in PH and 59 in PPP) were excluded. Fourteen incomplete forms from PH and 10 from PPP model hospital were also excluded. Responders rated perception on a 1-5 scale in each domain: accessibility of health-facility, time spent waiting, manner and quality of physician, manner and quality of nurse, manner and quality of supporting staff, perception of equipment, explanation of treatment details and general comfort. The responders also rated overall satisfaction on a 1-10 scale. In the 1-5 scale, rating≥4 in each domain was considered good. Rating≥8 in 1-10 scale was considered satisfaction. Responders from PPP-model hospital were significantly more satisfied than those from PH-model {n=529 (91.2%) vs. n=148 (32.1%) p<0.001}. This was true even when controlled for age-group, sex, maternal education, family-type, days of hospital-stay and socioeconomic class {O.R.(CI) =23.58 (16.13-34.48); p<0.001} by binary logistic regression model. In the PPP-model hospital the time spent waiting for treatment {4.28(2.07-8.82), p<.001} and manner of support staff {3.64(1.02-12.99), p=0.04} significantly predicted satisfaction. In PH-model hospital explanation given regarding treatment details significantly predicted overall satisfaction {2.99(1.61-5.54), p<.001}. Perceived quality of hospital care, as evidenced by the satisfaction and perception ratings of responders, was better in PPP-model hospital. This model could be emulated in developing countries to draw patients of lower socio-economic classes to tertiary-care public hospitals which are less expensive.

Healthcare public-private partnerships in Italy: Assessing risk sharing and governance issues with PESTLE and SWOT analysis

Healthcare infrastructural investments are a key strategic issue in countries such as Italy, whose aging population faces severe public budget constraints, exacerbated by the unprecedented recession. The choice between traditional procurement (TP) and Public Private Partnerships/Project Finance (PPP/PF) is by now a cornerstone of public strategies concerning complex infrastructural investments. PESTLE and SWOT strategic analysis provides a systematic and comprehensive reflection of the external and internal operational environment but has infrequently been applied to infrastructural procurement. Risk sharing between public and private actors and consequent corporate governance and ownership issues are still under-investigated in the literature, especially if associated with innovative PESTLE and SWOT instruments. Evidence shows that PESTLE and SWOT analysis improves procurement choices and public-private partnering, softening governance concerns. Since empirical considerations about Italy may be globally extended, even beyond the healthcare industry, the audience of this study may conveniently widen well beyond its apparently narrow focus.