Abstract
The context for health and hospital care will continue to change greatly. One area of change is ownership, between public, public-private partnership, private not-for-profit, and private for-profit. There are differences between formal and effective control, given that almost everywhere the state has a major role. Pseudo-markets can be created by a purchaser-provider split. Measurable performance differences between the various types is often ambiguous. Perhaps surprisingly, public hospitals are as efficient as private ones, but responsiveness is less. There should be different governance constraints to recognize the different types of provider. Guaranteeing universal access will require care in terms of contractability and accountability considerations, and bailout possibilities.
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Notes
- 1.
There are several other available typologies for PPP—see, for example, Barlow et al., Health Affairs, 2013. Some prominent PPP types such as a now almost famous Alzira model would not fit easily into the Montagu/Harding structure.
- 2.
According to Barlow et al. (2013) (footnote 1, above) these hospitals would be closer to a PPP than a ‘true’ private hospital: they are registered and committed to certain services in the state Krankenhausplan (hospital plan), contracted for the Krankenhausplan (sickness funds), and paid at the same DRG rate as public hospitals.
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Jeurissen, P., Maarse, H. (2020). Hospital Care: Private Assets for-a-Profit?. In: Durán, A., Wright, S. (eds) Understanding Hospitals in Changing Health Systems. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-28172-4_5
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