Soodabeh Vatankhah; Mohammadreza Maleki; Shahram Tofighi; Omid Barati; Sima Rafiei
Volume 9, Issue 3 , May and June 2012
Abstract
Public hospitals can privatize management activities by contracting with a private organization or person to perform the work. Management contract is a method which uses private sector for major government projects like hospitals. This review study evaluated management contract conditions in selected ...
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Public hospitals can privatize management activities by contracting with a private organization or person to perform the work. Management contract is a method which uses private sector for major government projects like hospitals. This review study evaluated management contract conditions in selected countries. We focused on services under contract, different forms of management contract, methods for monitoring contracts, effects of management contract on factors under study, and the payment system in management contract. Management contract is the most common type of privatizing management. In this method, the responsibility and control of a healthcare organization is granted to a person or a private organization. Contracting is used strategically to introduce market mechanisms while ensuring that essential public services are provided. Therefore, the government needs to recognize contracting as a powerful process, not just a cluster of independent transactions. This means that contracting initiatives must be regulated and monitored at the highest level of government by experienced and astute policy makers, economists and operational personnel. Keywords: Outsourcing; Hospitals, Public; Hospitals, Private; Management Contract.
Mohammad Amin Bahrami; Sudabeh Vatankhah; Sayed Jamaladin Tabibi; Sogand Tourani
Volume 8, Issue 3 , July and August 2011
Abstract
Introduction: Health system performance assessment provides appropriate information about the status of health systems for governments and communities. Therefore, in the recent decade, many countries have focused on performance assessment and reporting in order to develop methods and tools as a mean ...
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Introduction: Health system performance assessment provides appropriate information about the status of health systems for governments and communities. Therefore, in the recent decade, many countries have focused on performance assessment and reporting in order to develop methods and tools as a mean to help achieving health goals. The present study tries to design an indicator-based model (including general aspects and related indicators) for health system assessment in Iran.Methods: This descriptive comparative applied research was carried out during 2008-2009 and included three phases: reviewing theoretical concepts, preparing health system performance assessment indicators draft and building consensus. Required data was collected via environmental scanning and face to face and web-based interviewing. Environmental scanning did not include a study population and the models extracted through this stage were used as information sources. However, the study population during interview and building consensus phases consisted of 31 Iranian health system experts. The reliability and validity of forms used in interviews were confirmed by the experts and test-retest, respectively. We used a purposive approach and opportunistic sampling method to determine the interviewees. Modified Delphi technique was utilized for building consensus. In order to analyze the data, descriptive statistics (percent, mean and standard deviation) was applied. In the environmental scanning stage of research, performance assessment initiatives were identified in Canada, Australia, New Zealand, the United Kingdom and the United States. In addition, transnational performance assessment frameworks of the World Health Organization (WHO), Organization for Economic Cooperation and Development (OECD), the International Organization for Standardization (ISO), Commonwealth Fund and the United States Agency for International Development (USAID) were reviewed and existing indicators in Iran were collected. In the interviewing stage, indicators proposed by the interviewees were obtained. Finally, all identified indicators were classified in 31 criteria to form the initial draft of indicators. Results: For consensus building, 2 processes of modified Delphi were conducted. In the first process, after 4 rounds, 14 criteria were selected for Iranian health system performance assessment including public health status, governance, accessibility, health expenditure, financing and equity, primary health care, aging care, quality of services, insurance system, hospital performance, research and development, privatization, efficiency and productivity, technology and health information system and also health outcomes. In the second process of Delphi, consensus was obtained on 175 indicators. Conclusion: The designed result- and indicator–based model provides an instrument for reviewing country's health system. Applying this model will offer policy–makers a major opportunity for performance improvement over time. Keywords: Indicators; Performance Assessment; Healthcare Systems; Iran.
