Arrangements with the NHS for Providing Healthcare Services: Do They Improve Financial Performance of Private For-profit Hospitals in Spain?

Overview

Journal Health Econ Rev

Publisher Biomed Central

Specialty Public Health

Date 2021 Mar 10

PMID 33689038

Citations 1

Authors

Maria Victoria Ruiz-Mallorqui

Inmaculada Aguiar-Diaz

Beatriz Gonzalez-Lopez Valcarcel

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Nursing Homes: Affiliation to Large Chains, Quality and Public-Private Collaboration.

Aguiar-Diaz I, Ruiz-Mallorqui M, Gonzalez-Lopez Valcarcel B Healthcare (Basel). 2022; 10(8).

PMID: 36011087 PMC: 9408552. DOI: 10.3390/healthcare10081431.

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