The Perceived Impact of Privatization on Local Health Departments

Abstract

Privatization is part of a broader shift toward "managing" rather than directly providing public health services, yet privatization often reduces LHDs' control over the performance of services.

Outsourcing primary health care services—How politicians explain the grounds for their decisions

“…Problems related to health policy issues have been found by many authors [9,14,30,34,36,38]. Perhaps the observations of this study mirror that contracting is a fairly new activity in Finland, introduced in the 1990s [4].…”

“…A questionnaire was constructed by the authors based on a literature review (e.g. [2,9,12,[32][33][34][35][36]38]), on interviews of politicians in SM and on document analysis. Most of the concepts were measured by sum-scales having good reliability.…”

“…Issues seen as barriers are related to lack of a competitive market, lack of knowledge and expertise, and lack of sufficient information on the costs of alternative ways of provision [2,29,37]. Reported problems include concerns about accountability, fear of losing control over policy-making such as controlling costs and services, and ability to respond to crises [9,12,36,38].…”

“…Though several countries have contracted out health services, there are only a few studies dealing with the range and scope of PHC services outsourcing in developed countries [31,36,38]. Some studies have been also carried out in developing countries [8,11,12,18].…”

“…The questionnaire was designed by drawing on the findings from a literature review on the subject [2,9,12,[25][26][27][28][29][30][31][32][33][34][35][36]38], by interviewing politicians in SM about their opinions and experiences on outsourcing, and by analyzing minutes and planning documents from the municipalities. The questions about perceptions and experiences of politicians were organized under the following broad headings.…”