Efficiency in chronic illness care coordination: public-private collaboration models vs. traditional management

Abstract

Background The aim of this paper is to analyze the differences in the coordination of chronic illness care between the different public hospital management models coexisting in the Spanish region of Madrid (25 hospitals) during the period 2013–2017. Methods The performance of hospitals might be affected by the characteristics of the population they serve and, therefore, this information should be taken into account when estimating efficiency measures. For this purpose, we apply the nonparametric Data Envelopment Analysis (DEA) conditioned to some contextual variables and adapted to a dynamic framework, so that we can assess hospitals during a five-year period. The outputs considered are preventable hospitalizations, readmissions for heart failure and readmissions for chronic obstructive pulmonary disease, whereas the inputs considered are the number of beds, personnel (physicians and other healthcare professionals) and total expenditure on goods and services. Results The results suggest that the level of efficiency demonstrated by the public-private collaboration models of hospital management is higher than traditionally managed hospitals throughout the analyzed period. Nevertheless, we notice that efficiency differences among hospitals are significantly reduced when contextual factors were taken into account. Conclusions Hospitals managed under public-private collaboration models are more efficient than those under traditional management in terms of chronic illness care coordination, being this difference attributable to more agile and flexible management under the collaborative models.

Hospital services under public-private partnerships, outcomes and, challenges: A literature review

“…This model was judged to be more efficient in coordinating chronic disease care than traditional management models. 31 In line with the findings in Spain, a study in Iran showed an increase in performance and a significant difference between hospitals with PPP and traditionally managed hospitals on indicators such as bed turnover, average length of stay, and bed occupancy rate. 3 In contrast to the two findings above, the study of Karpagam et al showed the opposite.…”

“…This model was judged to be more efficient in coordinating chronic disease care than traditional management models. 31 In line with the 26 Wong et al, 27 Probandari et al 28 4.634 3 BMC Health Services Research Nuhu et al, 29 Diwan et al, 30 Franco Miguel et al, 31 18 Shorter delay until the adjuvant chemotherapy commences according to international recommendations is timely initiation of radiation therapy Kaliks et al 47 Duration from visiting the hospital to undergoing TB diagnostic test 0 day From diagnosis to initiation of treatment 6 days. In the term of care process, there were only slight differences between public and private hospitals, though private hospitals has better structural capacity than public hospitals Khetrapal et al 26 Around 19%−53% of Tuberculosis patients and 4%-18% of sputum smear positive Tuberculosis patients in hospitals participating in the PPM-DOTS strategy were not given standardized diagnosis and treatment as in DOTS Probandari et al 32 Hospital with PPP performed better compare to other hospital in the sense of availability of service, hemodialysis duration, and far more sessions of hemodialysis Liman et al 48 The endovascular procedure success-rate was 100%.…”

Efficiency in the governance of the Covid-19 pandemic: political and territorial factors

“…In our case, to determine the efficiency of pandemic management, the inputs refer to the resources available to manage a health crisis of these characteristics, and the outputs to its direct consequences. Thus, following the most recent literature analyzing efficiency in the health sector [ 17 , 29 ], the selected inputs are the available physicians ( Physicians ) and nurses ( Nurses ), the number of hospital beds ( Hospital beds ) and the current expenditure on health care ( Health expenditure ), while the number of people infected by Covid-19 ( Cases confirmed ) and the number of deaths ( Death rate ) form the outputs. Table 1 explains each input and output in more detail, as well as the sources of information and descriptive statistics.…”