Volume 16, Issue 4 (July 2022)
Qom Univ Med Sci J 2022, 16(4): 262-278 |
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Amirhosseini A, Shafiee Rudposhti M, Shirazi H, Jannatifar H. A Model for the Development of Public-private Partnerships in the Iranian Health System Using a Meta-Synthesis Approach. Qom Univ Med Sci J 2022; 16 (4) :262-278
URL: http://journal.muq.ac.ir/article-1-3444-en.html
URL: http://journal.muq.ac.ir/article-1-3444-en.html
1- Department of Business Management, Faculty of Humanities, Qom Branch, Islamic Azad University, Qom, Iran.
2- Department of Business Management, Faculty of Management and Accounting, University of Tehran, Tehran, Iran. ,maysam.shafiee@ut.ac.ir
3- Department of Management, Faculty of Humanities, Qom Branch, Islamic Azad University, Qom, Iran
4- Department of Management, Faculty of Humanities, Qom Branch, Islamic Azad University, Qom, Iran.
2- Department of Business Management, Faculty of Management and Accounting, University of Tehran, Tehran, Iran. ,
3- Department of Management, Faculty of Humanities, Qom Branch, Islamic Azad University, Qom, Iran
4- Department of Management, Faculty of Humanities, Qom Branch, Islamic Azad University, Qom, Iran.
Keywords: Development, Health system, Public-private partnership, Benefactors of health, Meta-Synthesis method
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Introduction
Countries in the world use the capacities of the private sector to achieve their development goals and delegate the implementation of some infrastructure projects in the fields of energy, power, telecommunications, transportation, healthcare, agriculture, and water to the private sector [1]. Infrastructure projects are divided into two categories of economic (e.g., public transport and energy including water, electricity, gas) and social (e.g., building stadiums, hospitals, schools and cultural centers) [2]. Governments have increased the role of private sectors in the provision of services in areas such as health care, and in access to resources that can meet infrastructure investment needs, project delivery and exploitation, advanced technologies, and sustainable development in infrastructure facilities and services [3]. One of the methods for increasing their role is in the form of a hybrid model named the public-private partnership (PPP) model that was introduced in 1990 [4]. In public-private partnerships, the government or a public organization collaborates with a private profit or non-profit organization to manage a part of the infrastructure project or the entire project [5]. In recent years, countries have expanded the sustainable public-private partnership structures to ensure public health [7]. Despite the increasing support for the participation of private sector in health care delivery, the lack of information can limit the ability of this sector to provide such services [8]. Iran’s health system, similar to the health system of other countries, faces challenges such as increased burden of chronic and non-communicable diseases, increase of the elderly population, increase of public expectations, and the increasing costs of the health sector [11]. To achieve development goals in country, the increase of finance by using the PPP model along with other financing methods is necessary [12].
According to Abikon, public-private partnerships in health has many benefits for countries, but has challenges such as the need for high efforts, high transaction costs (usually for the government), issues related to accountability, and sometimes inconsistency with the country’s priorities [13]. For this reason, more studies on health-related public-private partnerships need to be conducted. The present study aims to identify the dimensions and components of public-private partnerships in the health system and provide a conceptual model for the development of these partnerships in the health system.
Methods
The is a qualitative study using a Meta-Synthesis approach which was conducted based on the seven-step transversal method of Sandlowski and Barroso. The data were collected by reviewing articles related to the literature which were searched in valid national and international databases. Then, using the opinions of a panel of experts, the qualitative findings extracted from the articles were synthesized to finally discover new concepts. The critical appraisal skills programme (CASP) checklist was used to assess the quality of articles.
Results
The findings show that 27 articles were selected from the 217 extracted articles. After analyzing and combining the qualitative findings, 66 initial codes were extracted. Finally, according to the opinion of experts, the final results were categorized as 3 dimensions and 12 components, including: public sector (organizational and institutional, administrative and social, legal and regulatory, structural and contextual), private sector (economic and financial), banking and inflationary (technical and specialized, technology and equipment, legal and contractual), and charity sector (popularity and effectiveness, awareness and trust building, communication and interaction). The results are presented under the title of "A Model for the Development of Public-private Partnerships in the Iranian Health System Using a Meta-Synthesis Approach". Figure 1 shows the conceptual model of PPP in the health system.
Discussion
The previous studies have not reach a consensus on the various dimensions and components of PPP in the health system, due to low successful experiences in implementing this type of partnership in the private sector and low motivation and willingness of the public sector to provide the necessary conditions for the implementation of partnerships. This study, after identifying the effective dimensions and components, proposed a model of PPP to implement partnerships in the Iranian health system. By promoting economic, cultural and social capacities in the field of health, we can promote the quality of health services, social welfare, and general public satisfaction with the health system.
One of the limitations of the present study was the low successful experience of PPP implementation in the country’s health system and the unavailability of the full text of some studies. Further studies are recommended to conduct a study to investigate the causes of low PPP and how to make it sustainable in the health system of Iran. One of the strengths of this study was the use of Meta-Synthesis approach; instead of providing a summary of other findings, it provided a comprehensive and detailed view of the findings.
Ethical Considerations
Compliance with ethical guidelines
The authors declare that the ethical aspects of the research, including the confidentiality of information, have been observed in all its stages. Also, this article is the result of the doctoral thesis No. 1544865998699391400162451307 of Islamic Azad University, Qom Branch.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors contributions
Research design and data collection: Ali Amirhosseini and Meisham Shafiei Roudpashti; Data analysis: Hossein Shirazi and Maysam Shafiei Roudpashti; Final revision and approval: Hossein Shirazi, Maysam Shafiei Roudpashti and Hossein Jantifar.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors consider it necessary to appreciate and thank all those who have cooperated in this research.
Countries in the world use the capacities of the private sector to achieve their development goals and delegate the implementation of some infrastructure projects in the fields of energy, power, telecommunications, transportation, healthcare, agriculture, and water to the private sector [1]. Infrastructure projects are divided into two categories of economic (e.g., public transport and energy including water, electricity, gas) and social (e.g., building stadiums, hospitals, schools and cultural centers) [2]. Governments have increased the role of private sectors in the provision of services in areas such as health care, and in access to resources that can meet infrastructure investment needs, project delivery and exploitation, advanced technologies, and sustainable development in infrastructure facilities and services [3]. One of the methods for increasing their role is in the form of a hybrid model named the public-private partnership (PPP) model that was introduced in 1990 [4]. In public-private partnerships, the government or a public organization collaborates with a private profit or non-profit organization to manage a part of the infrastructure project or the entire project [5]. In recent years, countries have expanded the sustainable public-private partnership structures to ensure public health [7]. Despite the increasing support for the participation of private sector in health care delivery, the lack of information can limit the ability of this sector to provide such services [8]. Iran’s health system, similar to the health system of other countries, faces challenges such as increased burden of chronic and non-communicable diseases, increase of the elderly population, increase of public expectations, and the increasing costs of the health sector [11]. To achieve development goals in country, the increase of finance by using the PPP model along with other financing methods is necessary [12].
According to Abikon, public-private partnerships in health has many benefits for countries, but has challenges such as the need for high efforts, high transaction costs (usually for the government), issues related to accountability, and sometimes inconsistency with the country’s priorities [13]. For this reason, more studies on health-related public-private partnerships need to be conducted. The present study aims to identify the dimensions and components of public-private partnerships in the health system and provide a conceptual model for the development of these partnerships in the health system.
Methods
The is a qualitative study using a Meta-Synthesis approach which was conducted based on the seven-step transversal method of Sandlowski and Barroso. The data were collected by reviewing articles related to the literature which were searched in valid national and international databases. Then, using the opinions of a panel of experts, the qualitative findings extracted from the articles were synthesized to finally discover new concepts. The critical appraisal skills programme (CASP) checklist was used to assess the quality of articles.
Results
The findings show that 27 articles were selected from the 217 extracted articles. After analyzing and combining the qualitative findings, 66 initial codes were extracted. Finally, according to the opinion of experts, the final results were categorized as 3 dimensions and 12 components, including: public sector (organizational and institutional, administrative and social, legal and regulatory, structural and contextual), private sector (economic and financial), banking and inflationary (technical and specialized, technology and equipment, legal and contractual), and charity sector (popularity and effectiveness, awareness and trust building, communication and interaction). The results are presented under the title of "A Model for the Development of Public-private Partnerships in the Iranian Health System Using a Meta-Synthesis Approach". Figure 1 shows the conceptual model of PPP in the health system.
Discussion
The previous studies have not reach a consensus on the various dimensions and components of PPP in the health system, due to low successful experiences in implementing this type of partnership in the private sector and low motivation and willingness of the public sector to provide the necessary conditions for the implementation of partnerships. This study, after identifying the effective dimensions and components, proposed a model of PPP to implement partnerships in the Iranian health system. By promoting economic, cultural and social capacities in the field of health, we can promote the quality of health services, social welfare, and general public satisfaction with the health system.
One of the limitations of the present study was the low successful experience of PPP implementation in the country’s health system and the unavailability of the full text of some studies. Further studies are recommended to conduct a study to investigate the causes of low PPP and how to make it sustainable in the health system of Iran. One of the strengths of this study was the use of Meta-Synthesis approach; instead of providing a summary of other findings, it provided a comprehensive and detailed view of the findings.
Ethical Considerations
Compliance with ethical guidelines
The authors declare that the ethical aspects of the research, including the confidentiality of information, have been observed in all its stages. Also, this article is the result of the doctoral thesis No. 1544865998699391400162451307 of Islamic Azad University, Qom Branch.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors contributions
Research design and data collection: Ali Amirhosseini and Meisham Shafiei Roudpashti; Data analysis: Hossein Shirazi and Maysam Shafiei Roudpashti; Final revision and approval: Hossein Shirazi, Maysam Shafiei Roudpashti and Hossein Jantifar.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors consider it necessary to appreciate and thank all those who have cooperated in this research.
Type of Study: Original Article |
Subject:
مدیریت بهداشتی
Received: 2022/04/13 | Accepted: 2022/04/30 | Published: 2022/04/30
Received: 2022/04/13 | Accepted: 2022/04/30 | Published: 2022/04/30
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