Public-private partnerships in health care services: Do they outperform public hospitals regarding quality and access? Evidence from Portugal

Marques, Rui Cunha

doi:10.1016/j.seps.2020.100798

Cited by 55 publications

(43 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It offers new perspectives and a benchmarking tool for hospitals to maximize their performance, which may complement the analyses carried out before. For instance, because of the absence of a financial group of variables in Ferreira and Marques ( 2020 ) paper, their results about PPPs' relative performance and public hospitals can be somehow biased. It demands a new analysis for its managerial relevance, this time considering both financial and efficiency groups of variables.…”

Section: Resultsmentioning

confidence: 99%

“…Like other firms, public hospitals must be financially, socially, and environmentally sustainable. For instance, hospitals intend to improve patients' life quality, through the best assistance, with a minimum of waste (Ferreira and Marques, 2020 ). Profit is not the primary goal of public hospitals in Portugal.…”

Section: Introductionmentioning

confidence: 99%

“…In other words, the authors constructed a CI using a DEA-like model just for evaluating the financial performance of hospitals in Greece. Meanwhile, Ferreira and Marques ( 2020 ) analyzed Portuguese public–private partnerships in health care, considering a few quality and access indicators and the construction of CIs. Still, those authors disregarded both the financial and the efficiency-productivity components.…”

Section: Introductionmentioning

confidence: 99%

“…In this case, a linear programming tool optimizes weights or multipliers associated with indicators. The former allows the simultaneous reduction of the undesirable variables and the increase of the desirable ones at different rates (Ferreira and Marques 2020 ). This efficiency approach allows hospital classification and rankings construction.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Economic Analysis of Portuguese Public Hospitals Through the Construction of Quality, Efficiency, Access, and Financial Related Composite Indicators

2021

View full text Add to dashboard Cite

Hospitals consume most of the health systems' financial resources. In Portugal, for instance, public hospitals represent more than half of the National Health Service debt and are decisive in their financial insufficiency. Although profit is not the primary goal of hospitals, it is essential to guarantee their financial sustainability to ensure users' health care and the necessary resources. An analysis of the existing literature shows that researches focus mainly on the hospital's technical efficiency. The literature has paid little or even no attention to the use of composite indicators in hospital benchmarking studies. This study uses the Benefit of Doubt methodology alongside recent data about Portuguese public hospitals (2013–2017) to understand the factors that contribute to low performance and high indebtedness levels. Our results suggest that hospitals perform better in terms of access (average score: 0.982). The group of criteria with the lowest performance was efficiency and productivity (average score: 0.919), suggesting resources waste. Financial performance is, in general, higher than quality, raising social concerns about the way that public hospitals have been managed. Findings bring relevant implications. For example, the way hospitals are currently financed should consider efficiency, productivity, quality, and access. Regulators should ensure that minimum performance levels are fulfilled, applying preventive and corrective measures to avoid future low-performance levels. We suggest that hospital managers introduce satisfaction inquiries to improve quality. These improvements can attract more patients in the medium- or long-term; thus, our results are useful to citizens to make a better choice.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Economic Analysis of Portuguese Public Hospitals Through the Construction of Quality, Efficiency, Access, and Financial Related Composite Indicators

2021

View full text Add to dashboard Cite

show abstract

“…Some other studies focus on PPPs' application on healthcare infrastructure building, while projects in multiple countries have been investigated. Evidence from Portugal's hospitals indicates that PPP hospitals and public hospitals provide healthcare services with similar quality and access [23]. Another study based on a single case in the New Mestre Hospital of Italy suggests that PPP projects should also take into account the risk of uncertainty, the beneficial effect on health services, and the interests of the general public [24].…”

Section: Public-private Partnerships: Concept and Applicationmentioning

confidence: 99%

Public-Private or Master-Servant? Examining the Implementation of the Serious Disease Insurance Scheme in China

Liu

Shen³

2020

IJERPH

View full text Add to dashboard Cite

China’s Serious Disease Insurance Scheme (SDIS) was set up to relieve the financial burdens on serious disease patients. It is a crucial part of the national basic medical insurance scheme, which is regarded as one of the largest government-funded social security programs in the world. The most significant institutional innovation of the SDIS is that the approach of a public–private partnership (PPP) is applied in an attempt to facilitate the efficiency of its implementation. The objective of this paper is to evaluate the implementation of the SDIS in China through PPPs, and to identify the problems to be tackled if the Chinese government intends to make such a plan work better for the majority of urban and rural residents. With the effective support from local officials and practitioners, the authors of this paper collected copies of SDIS contracts of multiple cities in Guangdong, one of the most developed provinces of China. Guided by a research framework drawn from the PPP literature, details of contract enforcement were also examined. The authors discovered that the role of local states is rather dominant; they have manipulated contract drafting and implementation. Additionally, current mechanisms for profit sharing, risk sharing, and information exchange have placed insurance companies in a rather disadvantageous situation. To achieve the sustainable development of the SDIS, the authors suggest that a further reform on implementation of a PPP must be pushed forward.

show abstract

Vertical integration in healthcare: What does literature say about improvements on quality, access, efficiency, and costs containment?

Amado

Marques

Nunes

2022

Health Planning & Management

View full text Add to dashboard Cite

Introduction: Vertical integration models involve integrating services from different levels of care (e.g., primary care, acute care, post-acute care). Therefore, one of their main objectives is to increase continuity of care, potentially improving outcomes like efficiency, quality, and access or even enabling cost containment.Objectives: This study conducts a literature review and aims at contributing to the contentious discussion regarding the effects of vertical integration reforms in terms of efficiency, costs containment, quality, and access.Methods: We performed a systematic search of the literature published until February 2020. The articles respecting the conceptual framework were included in an exhaustive analysis to study the impact of vertical integration on costs, prices of care, efficiency, quality, and access.Results: A sample of 64 papers resulted from the screening process. The impact of vertical integration on costs and prices of care appears to be negative. Decreases in technical efficiency upon vertical integration are practically out of the question. Nevertheless, there is no substantial inclination to visualise a positive influence. The same happens with the quality of care. Regarding access, the lack of available articles on this outcome limits conjectures.Conclusions: In summary, it is not clear yet whether vertically integrated healthcare providers positively impact the overall delivery care system. Nevertheless, the recent grow-

show abstract

Public-private partnerships in health care services: Do they outperform public hospitals regarding quality and access? Evidence from Portugal

Cited by 55 publications

References 65 publications

Economic Analysis of Portuguese Public Hospitals Through the Construction of Quality, Efficiency, Access, and Financial Related Composite Indicators

Economic Analysis of Portuguese Public Hospitals Through the Construction of Quality, Efficiency, Access, and Financial Related Composite Indicators

Public-Private or Master-Servant? Examining the Implementation of the Serious Disease Insurance Scheme in China

Vertical integration in healthcare: What does literature say about improvements on quality, access, efficiency, and costs containment?

Contact Info

Product

Resources

About