An Analysis of Public-Private Partnership Models in Hospital Management: A Scoping Review

Introduction Growth of health expenditures, financial limitations, low efficiency and quality of service provision in public hospitals and ever-increasing expectations have obligated healthcare systems to utilize private sector’s capabilities. According to other countries’ experiences, public-private partnership (PPP) is a solution that not only reduces defects of every sectors, but also integrates both sectors’ advantages. This study was aimed to review PPP models in hospital management and propose suggestions for best model selecting in different situations. In this study, after organizing questions as well as determining search strategies, opted articles were assessed deeply; definitions as well as different PPP models’ pros and cons in hospitals management were analyzed; and finally, these models were compared according to quality-effectiveness, access, financial efficiency, and risk sharing indicators. By reviewing 32 peer-reviewed articles, PPP models were categorized in service providing, financing as well as developing infrastructures, and compound levels. Based on the results, “clinical outsourcing” and “management contract” have attained high level in access and quality-effectiveness indicators and “BOO”, “DBFO”, and “clinical outsourcing” models have achieved high level in financial efficiency. Furthermore, “operating contract” and “privatization” are placed in two ends of risk sharing spectrum. Finally, “outsourcing”, “management”, and “lease” contracts are advised to improve productivity of public hospitals; and “BOO”, “BOT”, as well as “DBFO” models are advised to develop infrastructures and increase the number of hospitals beds. Considering hospital management challenges and health economics specifications, utilizing public-private partnership models is a vital issue to fulfill the aims of healthcare system.