Public-private partnerships in health care services

This research compares Portuguese hospital public-private partnerships (PPP) with the corporatized hospitals (EPE) regarding their social performance, between 2012 and 2017.

The research accompanies a line of inquiry on whether hospital PPPs are more or less efficient than the traditional model of managing hospitals by focusing on the social side of health care. There is a generalized idea in the public that this type of partnership translates into ruinous contracts for the public purse and poorer health care services. This idea rests in three main premises: i) the State’s inability to take advantage of the private partner’s competitive potential and risk management capacity; ii) poor contract management by the State; and iii) an optimism bias associated with an overestimation of the demand for health care services that is normally associated with a transfer of wealth from the State to the private partner.

The paper adopts a benchmarking model, alongside a complete set of data on quality and access dimensions that are monitored by the Ministry of Health. The results suggests that PPP hospitals can deliver health care services with clinical response capacity levels at least as good as EPEs.

This research contributes data and analysis to an intense debate around PPPs. It partly demystifies the populistic idea that PPPs in health care do not serve the purpose of improving the health status of their patients.

Click here to go to the paper by Diogo C. Ferreira and Rui C. Marques.