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Arrangements with the NHS for providing healthcare services: do they improve financial performance of private for-profit hospitals in Spain?

BACKGROUND: In developed countries around the world there is a trend to enhance the public-private collaboration in healthcare. In Spain, a decentralized country with a NHS funded with taxes and universal coverage, commissioning to for-profit private hospitals the production of healthcare services t...

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Autores principales: Ruiz-Mallorquí, María Victoria, Aguiar-Díaz, Inmaculada, González- López Valcárcel, Beatriz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944633/
https://www.ncbi.nlm.nih.gov/pubmed/33689038
http://dx.doi.org/10.1186/s13561-021-00304-4
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author Ruiz-Mallorquí, María Victoria
Aguiar-Díaz, Inmaculada
González- López Valcárcel, Beatriz
author_facet Ruiz-Mallorquí, María Victoria
Aguiar-Díaz, Inmaculada
González- López Valcárcel, Beatriz
author_sort Ruiz-Mallorquí, María Victoria
collection PubMed
description BACKGROUND: In developed countries around the world there is a trend to enhance the public-private collaboration in healthcare. In Spain, a decentralized country with a NHS funded with taxes and universal coverage, commissioning to for-profit private hospitals the production of healthcare services to specific patients that are publicly insured is a traditional practice. Around 43% of the for-profit private hospitals in Spain have a commissioning agreement with the NHS to diagnose or treat patients on public tariffs. These revenues represent 26% of the total revenues of private for-profit hospitals. The research question of this study is if commissioning with the NHS improves the financial performance of private-for-profit hospitals in Spain. METHODS: With a long panel (2000–2017) of for-profit hospitals we estimate a model for the financial performance (return on assets) using commissioning as main explanatory variable and other variables as control (variables financial indicators and structural information). Specific models are estimated for subgroups of hospitals according to size and specialization. The models are estimated by panel regression with fixed effects and GMM as robustness. RESULTS: Private for-profit hospitals that have commissioning with NHS obtain higher financial performance than no-commissioning hospitals. This effect varies depending on hospital size and type (hospital specialization), the advantage being more relevant for general hospitals and particularly for hospital with at least 50 beds. CONCLUSIONS: Commissioning with the NHS is a promising source of financial profitability for general acute private for-profit hospitals. The evidence provided by this study may orientate the NHS in the regulation and negotiation of commissioning contracts in healthcare. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13561-021-00304-4.
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spelling pubmed-79446332021-03-10 Arrangements with the NHS for providing healthcare services: do they improve financial performance of private for-profit hospitals in Spain? Ruiz-Mallorquí, María Victoria Aguiar-Díaz, Inmaculada González- López Valcárcel, Beatriz Health Econ Rev Review BACKGROUND: In developed countries around the world there is a trend to enhance the public-private collaboration in healthcare. In Spain, a decentralized country with a NHS funded with taxes and universal coverage, commissioning to for-profit private hospitals the production of healthcare services to specific patients that are publicly insured is a traditional practice. Around 43% of the for-profit private hospitals in Spain have a commissioning agreement with the NHS to diagnose or treat patients on public tariffs. These revenues represent 26% of the total revenues of private for-profit hospitals. The research question of this study is if commissioning with the NHS improves the financial performance of private-for-profit hospitals in Spain. METHODS: With a long panel (2000–2017) of for-profit hospitals we estimate a model for the financial performance (return on assets) using commissioning as main explanatory variable and other variables as control (variables financial indicators and structural information). Specific models are estimated for subgroups of hospitals according to size and specialization. The models are estimated by panel regression with fixed effects and GMM as robustness. RESULTS: Private for-profit hospitals that have commissioning with NHS obtain higher financial performance than no-commissioning hospitals. This effect varies depending on hospital size and type (hospital specialization), the advantage being more relevant for general hospitals and particularly for hospital with at least 50 beds. CONCLUSIONS: Commissioning with the NHS is a promising source of financial profitability for general acute private for-profit hospitals. The evidence provided by this study may orientate the NHS in the regulation and negotiation of commissioning contracts in healthcare. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13561-021-00304-4. Springer Berlin Heidelberg 2021-03-10 /pmc/articles/PMC7944633/ /pubmed/33689038 http://dx.doi.org/10.1186/s13561-021-00304-4 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Ruiz-Mallorquí, María Victoria
Aguiar-Díaz, Inmaculada
González- López Valcárcel, Beatriz
Arrangements with the NHS for providing healthcare services: do they improve financial performance of private for-profit hospitals in Spain?
title Arrangements with the NHS for providing healthcare services: do they improve financial performance of private for-profit hospitals in Spain?
title_full Arrangements with the NHS for providing healthcare services: do they improve financial performance of private for-profit hospitals in Spain?
title_fullStr Arrangements with the NHS for providing healthcare services: do they improve financial performance of private for-profit hospitals in Spain?
title_full_unstemmed Arrangements with the NHS for providing healthcare services: do they improve financial performance of private for-profit hospitals in Spain?
title_short Arrangements with the NHS for providing healthcare services: do they improve financial performance of private for-profit hospitals in Spain?
title_sort arrangements with the nhs for providing healthcare services: do they improve financial performance of private for-profit hospitals in spain?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944633/
https://www.ncbi.nlm.nih.gov/pubmed/33689038
http://dx.doi.org/10.1186/s13561-021-00304-4
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