Public–Private Partnerships for Sustainable Healthcare in Emerging Economies

Visconti, Roberto Moro; Anna, Doś; Gürgün, Aslı Pelin

doi:10.1108/978-1-78714-493-420171015

Cited by 17 publications

(15 citation statements)

References 18 publications

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“…The P4P model should adequately consider a system of economic incentives for private players acting together with public actors in a PPP/PF agreement. This coordination is consistent with a PPP model that is widely used in healthcare [37]. P4P is complementary to mHealth and remunerates digital efforts and convergence to electronic health records.…”

Section: Pay-for-performance Incentivessupporting

confidence: 80%

Healthcare Digitalization and Pay-For-Performance Incentives in Smart Hospital Project Financing

Visconti

Morea

2020

IJERPH

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This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by pay-for-performance (P4P) incentives. Digital platforms are a technology-enabled business model that facilitates exchanges between interacting agents. They represent a bridging link among disconnected nodes, improving the scalable value of networks. Application to healthcare public-private partnerships (PPPs) is significant due to the consistency of digital platforms with health issues and the complexity of the stakeholder's interaction. In infrastructural PPPs, public and private players cooperate, usually following PF patterns. This relationship is complemented by digitized supply chains and is increasingly patient-centric. This paper reviews the literature, analyzes some supply chain bottlenecks, addresses solutions concerning the networking effects of platforms to improve PPP interactions, and investigates the cost-benefit analysis of digital health with an empirical case. Whereas diagnostic or infrastructural technology is an expensive investment with long-term payback, leapfrogging digital applications reduce contingent costs. "Digital" savings can be shared by key stakeholders with P4P schemes, incentivizing value co-creation patterns. Efficient sharing may apply network theory to a comprehensive PPP ecosystem where stakeholding nodes are digitally connected. This innovative approach improves stakeholder relationships, which are re-engineered around digital platforms that enhance patient-centered satisfaction and sustainability. Digital technologies are useful even for infectious disease surveillance, like that of the coronavirus pandemic, for supporting massive healthcare intervention, decongesting hospitals, and providing timely big data. not due to population aging per se, but to the increase in demand for new medical technologies that improve and/or extend life as real per-capita incomes grow [3,4].Within this evolving framework, technology is a double-edged sword, since it increases healthcare expenditure [5] but can also bring savings and quality-of-life improvements [6]. The relationship between medical technology and spending is complex and often conflicting. The impact of technology on costs differs across technologies, in that some (e.g., cancer drugs, invasive medical devices) have significant financial implications, while others are cost-neutral or cost-saving [7]. Medicine in the 21 st century is increasingly dependent on technology. Unlike in many other areas, the cost of medical technology is not declining, and its increasing use contributes to spiraling healthcare costs. Many medical professionals equate progress in medicine to the growing use of sophisticated technology, which is often expensive and beyond the reach of the average citizen [8].Whereas technology concerning tangible items, such as diagnostic equipment or physical infrastructure, has an uncertain cost-benefit trade-off, digital investments have a shorter payback, are typically cheaper, and show sounder benef...

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Section: Pay-for-performance Incentivessupporting

confidence: 80%

Healthcare Digitalization and Pay-For-Performance Incentives in Smart Hospital Project Financing

Visconti

Morea

2020

IJERPH

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“…However, considering the diversity of medical facilities and complexity of performance measurements, PPP in healthcare was also confronted with challenges [50]. A previous study from Italy suggested that irrational and ill-advised development could spoil the sustainability of PPP healthcare [14]. Torchia and Calabrò underlined a critical issue: compared with other fields, the health landscape had been taking a period of enormous change, including clinical technologies, models of care, and epidemiological trends; thus, the uncertainty was largely magnified [51].…”

Section: Ppp In Healthcare Service Deliverymentioning

confidence: 99%

“…Private capital involved in medical delivery via PPP could expand the source of funds, improve the operational efficiency of healthcare facilities [13], strengthen their own market competitiveness, and acquire opportunities for future investment. Emerging countries are considered a proper market in extensively promoting PPP to improve the quality of medical infrastructures [14]. Four representative types are applied for private sector investment in CHM via PPP modality, namely, build-operate-transfer (BOT), renovateoperate-transfer (ROT), transfer-operate-transfer (TOT), operation and management contracts (O&M) [15] (Table 1).…”

Section: Introductionmentioning

confidence: 99%

“…Firstly, numerous private capital entities, including construction companies and property developers, lack technical knowledge and experience to operate healthcare facilities [16]. Secondly, considering certain differences among medical entities, setting appropriate key indicators to evaluate performance for private participators as payment basis is difficult [14]. irdly, private specialist clinics are still not allowed to establish property relation with public general hospitals in several core medical services owing to policy restrictions [17].…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the Intention and Behaviour of Private Sector Participation in Healthcare Service Delivery via Public-Private Partnership: Evidence from China

Yang

Song

Yao

et al. 2020

Journal of Healthcare Engineering

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Private sector participation in the healthcare market via public-private partnership (PPP) could be considered an available approach to narrow down the medical resource gap and improve the operational efficiency of healthcare facilities. Accordingly, this study aims to examine the influence and relative importance among critical factors for the intention and behaviour of the private sector towards participation in Chinese healthcare market (CHM) via PPP. We defined five hypotheses from previous literature and built a theoretical model based on modified theory of planned behaviour. Then, covariance-based structural equation modelling was applied to analyse the questionnaires provided by 248 respondents from construction companies, real estate developers, pharmaceutical companies, private hospitals, asset management companies, and medical industry property investment companies in China. Results indicated that attitude towards behaviour (β = 0.466, P<0.001), subjective norm (β = 0.167, P<0.05), perceived behavioural control (β = 0.231, P<0.01), and facilitating conditions (β = 0.305, P<0.001) are positively significant to behavioural intention; behavioural intention also shows a strong linkage with behaviour (β = 0.931, P<0.001). Findings provide reference for governments and public authorities to exert additional efforts in implementing appropriate measures that will stimulate the private sector’s motivation to participate in CHM via PPP.

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“…Healthcare PPP investments remain controversial [25,26], and key concepts like the public sector comparator or the value for money are hotly debated [27][28][29]. This concerns the entire PPP process, typically backed by PF, from project and design to construction and management.…”

Section: Literature Reviewmentioning

confidence: 99%

Can Public-Private Partnerships Foster Investment Sustainability in Smart Hospitals?

et al. 2019

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This article addresses the relationship between Public-Private Partnerships (PPP) and the sustainability of public spending in smart hospitals. Smart (technological) hospitals represent long-termed investments where public and private players interact with banking institutions and eventually patients, to satisfy a core welfare need. Characteristics of smart hospitals are critically examined, together with private actors’ involvement and flexible forms of remuneration. Technology-driven smart hospitals are so complicated that they may require sophisticated PPP. Public players lack innovative skills, whereas private actors seek additional compensation for their non-routine efforts and higher risk. PPP represents a feasible framework, especially if linked to Project Financing (PF) investment patterns. Whereas the social impact of healthcare investments seems evident, their financial coverage raises growing concern in a capital rationing context where shrinking public resources must cope with the growing needs of chronic elder patients. Results-Based Financing (RBF) is a pay-by-result methodology that softens traditional PPP criticalities as availability payment sustainability or risk transfer compensation. Waste of public money can consequently be reduced, and private bankability improved. In this study, we examine why and how advanced Information Technology (IT) solutions implemented in “Smart Hospitals” should produce a positive social impact by increasing at the same time health sustainability and quality of care. Patient-centered smart hospitals realized through PPP schemes, reshape traditional healthcare supply chains with savings and efficiency gains that improve timeliness and execution of care.

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Public–Private Partnerships for Sustainable Healthcare in Emerging Economies

Cited by 17 publications

References 18 publications

Healthcare Digitalization and Pay-For-Performance Incentives in Smart Hospital Project Financing

Healthcare Digitalization and Pay-For-Performance Incentives in Smart Hospital Project Financing

Evaluating the Intention and Behaviour of Private Sector Participation in Healthcare Service Delivery via Public-Private Partnership: Evidence from China

Can Public-Private Partnerships Foster Investment Sustainability in Smart Hospitals?

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