PPP hospitals: evidence for deliveries and impact of the Caesarean rate in a European country

ABSTRACT

Public–private partnerships (PPPs) have been increasingly used for hospital management in Portugal since 2008. At the same time, births received special attention given the urgent need to reduce the rate of Caesarean sections performed, which was one of the highest in Europe. This paper analyses clinical performance differences between Portuguese PPPs and public hospitals in the case of deliveries. The evidence obtained was mixed, implying that a case by case evaluation of PPP benefits is required.

IMPACT

The research reported here was intended to find empirical evidence to help decision-makers choose between providing clinical services via a PPP or entirely by the public sector. The study focused on Portugal’s very high rate of Caesarian sections and incentives provided to both public sector and PPP hospitals to reduce this number. There were no general benefits in PPP hospitals; some benefits were found which were hospital specific. Managers need to evaluate a PPP hospital’s performance in a group of homogeneous hospitals when considering extending or renewing PPP management contracts.

KEYWORDS:

• Caesareans
• deliveries
• inpatient days
• public hospitals
• public–private partnership

Disclosure statement

No potential conflict of interest was reported by the author(s).