The challenges of public private partnership in hospital operations: A case study

Public private partnership (PPP) is a good strategy to increase the capacity and efficiency of the public sector and to deliver high quality healthcare services to the community at a lower price for the government. However, there are several challenges related to PPP in Iranian health sector. Moheb-Yas hospital is one of the few hospitals built with the PPP method in Iran. The purpose of this study is to identify, explore, and explain the challenges of PPP in Moheb Yas hospital operations.
Methods This case study was carried out in 2018 using semi-structured interviews, documentation, archival records, and direct observation. Twenty-four key stakeholders involved in the establishment and operations of the hospital were purposefully selected and interviewed. Content analysis was used for data analysis. Moheb-Yas hospital PPP faced legal, structural, human related, cultural and managerial challenges. These challenges include vague and unclear model of partnership, political changes, insufficient supportive regulations and rules, design and built problems, limited utilization of the hospital capacity, lack of long term funding, employees’ low job security, unequal employees’ compensation, cultural differences, insufficient conflict management and resolution, management turnover and lack of participative management. The PPP experience in Moheb-Yas hospital was unsuccessful. Political support, stable economic condition, establishing a PPP unit, strong leadership, proper planning, trust and mutual responsibility are necessary for the success of PPP in the health sector.