Models of "Public-Private Partnership" and their Effects on Hospital Mid-Indicators: A Critical Review

Public-private partnership can help governments deal with resource constraints in their health sectors. The aim of this study was to investigate the effects of different models of public-private partnership on hospital mid-indicators and identify factors affecting its successful implementation. This critical review was conducted from 2000 to 2017. Databases, such as Google Scholar, Ovid, Proquest, PubMed, Science Direct, Scopus, Springer, Magiran, SID, IranMedex and Irandoc were searched using Persian and English key terms.
Critical Appraisal Skills Program was used to assess the quality of papers which were ranked based on evidence pyramid. The factors influencing the successful implementation of public-private partnership in hospitals were identified through content analysis method. A total of 20 articles were included in the study. Six models of public-private partnership, that is, the Alzira Model, Design, Build, Finance, Operate Contract/ Private Finance Initiative, Management contract, Co-location and Outsourcing, and Privatization were used in hospitals. Each model has different effects on equity, quality, efficiency and accessibility. The factors influencing the successful implementation of public-private partnership projects included: legal support, political support, financial incentives and capacity building. Public-private partnership models showed different effects on hospital mid-indicators. It seems that the Design, Build, Finance, Operate Contract/ Private Finance Initiative آا
model is more suitable for construction projects, management contract, and outsourcing and Alzira model is appropriate for delivering hospital services. Therefore, health policymakers can apply different models of public-private partnership on the basis of their effects on hospital mid-indicators.