Exposure of Public Sector with the Quasi-Market Through Outsourcing: A Case Study in Iran (original) (raw)
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Archives of Medical Science, 2014
A b s t r a c t Introduction: The costs of health care in Poland are continuously increasing. Thus, almost every institution providing medical services aims at their limitation. One of the costs rationalisation methods in the health care sector is outsourcing. Material and methods: The study was conducted in 153 randomly selected institutions providing medical activities. The tool was a questionnaire, available via a web browser. Results: Over 30% of public institutions identified the need for financial savings, as the main reason for outsourcing the cleaning function. Among private institutions, the dominant reason for this is too high maintenance cost of the cleaning staff (less than 40% of responses). The huge number of medical institutions use the services of an external company for laundering. Over 30% of public institutions identified as the most common reason for separation of functions laundering lack of resources to upgrade and modernize facilities. Less than 27% of public institutions indicate too high costs of kitchen staff as the main reason for ordering function of feeding. Another reason is the need for financial savings (22% response rate). Some institutions indicate a desire to focus on key areas (20% of responses) and lack of financial resources to upgrade and modernize the kitchen (20% response rate). Public and private institutions exercise control over the quality and method performed by an external service (71% of public institutions and 59% of private institutions). Private institutions often informally exercise external control (difference confirmed -Fisher's exact test). Less than 90% of public institutions indicated satisfaction with the services provided by external companies. Conclusions: The adaptation of outsourcing in medical facilities leads to financial efficiency improvement. Through the separation of some medical functions and entrusting their realisation to external companies, medical institutions can focus on their basic activity that is the provision of health services.
Propensity of the managers to outsource hospital services in Shiraz, Iran
South East Asia Journal of Public Health, 2015
Contracting out of health services to the private sectors has been the subject of extensive debate and discussion among health personnel and policymakers. Outsourcing is now considered as a useful management tool for health care managers in the public sector. Outsourcing increases efficiency and service quality, reduces costs, focuses on core processes, improves skills, enhances the overall competitive advantages of the organization, and creates effective occupations in the private sector. The present study aimed to determine the present status of outsourcing hospital services (i.e. radiology, laboratory, nursing, and nutrition) to the private sectors and the propensity of the managers to outsourcing services in six hospitals affiliated to Shiraz University of Medical Sciences, Iran. The study was conducted in six hospitals of Shiraz, Iran in 2012. The study population included all hospitals managers and the sample size was 24. The findings of the study revealed that nutrition, radi...
Outsourcing in Shiraz University of Medical Sciences; a before and after study
Journal of the Egyptian Public Health Association
Background: Outsourcing is a kind of participation between public and private sector. This should be monitored and supervised to enhance the quality of outsourced services and to prevent new problems in this area. Shiraz University of Medical Sciences (SUMS) hospitals increasingly use outsourcing in recent years. Objectives: The present research aimed at comparing outsourced departments of SUMS from economic view, accessibility of services, and service quality during the years 2010-2012. Methods: A before and after descriptive and analytical design was applied in outsourced departments of SUMS in 2014. First, 17 indicators were extracted by Delphi technique. Then, all outsourced units were assessed using economic, access to services, and quality indicators during 2010 to 2012. Results: After outsourcing, in all pharmacies and dentistry units, except one, loss decreased and benefit increased from public sector viewpoint. The number of personnel for one pharmacy and two laboratories was decreased, while it remained unchanged for dentistry units. The total number of clients was increased for all pharmacies and laboratories and decreased for one dentistry unit. Patient satisfaction for pharmacies, laboratories, and dentistry units was 73.4%, 80.3%, and 78.5%, respectively. Also, employer's satisfaction from contraction was 60%, 68%, and 93.3% for pharmacies, laboratories, and dentistry units, respectively. Conclusion: Outsourcing as an effective strategy resulted in increase in the personnel, client, and stakeholder satisfaction. Also, it increased benefit and decreased cost for public sector. It is recommended that rules for the implementation of this strategy and monitoring the private sector should be defined.
Outsourcing in Iranian hospitals: Findings from a qualitative study
The International Journal of Health Planning and Management, 2018
Outsourcing is used as a strategy to improve efficiency, quality, and satisfaction of beneficiaries in hospitals. This study aimed to determine the reasons for outsourcing, outsourced services, achieved objectives, and outsourcing challenges. This qualitative study was conducted through 58 face-toface semi-structured interviews with chief executive officers (CEOs), chief financial officers (CFOs), and contracting experts (CEs) in 42 public hospitals in Tehran, Iran. Purposive and snowball sampling techniques were used. Interviews were recorded digitally and transcribed verbatim. Data analysis was performed based on an inductive-deductive approach via MAXQDA-10. The Participants included 26 CEOs, 15 CFOs, and 17 CEs. The most important reasons for outsourcing were divided into four main categories including financial resources and funding, customers, management, and factors related to the hospitals. Accessing to up-to-date knowledge and technology, improving service quality and accountability, focusing on strategic points, reducing workload, and increasing patient satisfaction turned out to be the positive outcomes of outsourcing.
2012
Background: The inefficiency of financing health care in developing countries made led in many health policy-makers to consider alternate means of service provisions. Outsourcing public financed health services in private sector organization is one of the interventions. Advocates claim that the contracting out of health care services will improve the service delivery performances through stimulating competition among providers and also by creating economic incentives to improve performance through linking payment to provider performance. Materials and methods: The purpose of this cross sectional study was to provide decision matrix to guide decision-makers whether outsource hospital services or not. Tow kind of questionnaire were developed and used. Results: Findings showed that the most propensities of outsource is in nutrition services (87%), and the least is in nursing services (43.4%) based on administrators' attitude. Shaping of decision matrix showed propensity to outsourcing of nursing, radiology, laboratory services are high while nutrition services is been low. Conclusion: Finding showed some differences between results of decision matrix and administrators' propensity to outsourcing in radiology and laboratory services. Lack of attention in characteristics of the hospital services might be one of the reasons. Cost saving is the main reason for outsourcing the services while administrators should consider as an effect and side effect of outsourcings.
Outsourcing in Turkish Hospitals: A Systematic Review
Dış kaynak kullanımı devlet hastanelerinde temel bir strateji haline gelmekte ve son zamanlarda tanınırlığı artmaktadır. Türkiye'de bu trendi oluşturan itici güç, özel sektördeki baskıların ve rekabetin kamu sektörünü daha verimli kılacağı gerçeğine dayanarak Sağlık Bakanlığı tarafından başlatılmıştır. Bu çalışmanın amacı, sistematik analiz yoluyla Türkiye'deki hastanelerde dış kaynak kullanımı konusunda elde edilen farklı araştırma bulgularını karşılaştırmak, bütünleştirmek ve gelecekteki araştırmalara yönelik öneride bulunmaktır. Analizde 2005 ve 2011 yılları arasında yayınlanmış toplam 15 çalışma (8 tez, 7 makale) kapsama alınmıştır. Bu çalışmaların sonuçlarına göre, dış kaynak kullanımının maliyetleri azalttığı, verimliliği ve hizmetlerin kalitesini artırdığı bulunmuştur. Sadece bir çalışmada dış kaynak kullanımının hastane maliyetlerine etkisi hastane kayıtlarına dayalı olarak incelenmiştir. Başka bir çalışmada ise hastane çalışanlarının memnuniyet düzeyi düşük bulunmuştur. Sonuç olarak, Türkiye'deki kamu ve özel hastanelerde dış kaynaklardan yararlanılarak verilen hizmetlerin etkilerini belirleyen objektif kalite, verimlilik ve maliyet indikatörlerine dayalı ampirik araştırmalara gereksinim duyulduğu söylenebilir.
Journal of Hospital, 2012
Background: The inefficiency of financing health care in developing countries made led in many health policy-makers to consider alternate means of service provisions. Outsourcing public financed health services in private sector organization is one of the interventions. Advocates claim that the contracting out of health care services will improve the service delivery performances through stimulating competition among providers and also by creating economic incentives to improve performance through linking payment to provider performance. Materials and methods: The purpose of this cross sectional study was to provide decision matrix to guide decision-makers whether outsource hospital services or not. Tow kind of questionnaire were developed and used. Results: Findings showed that the most propensities of outsource is in nutrition services (87%), and the least is in nursing services (43.4%) based on administrators’ attitude. Shaping of decision matrix showed propensity to outsourcing ...
Outsourcing and Its Implications for Hospital Organizations in Turkey
Journal of health care finance
To thrive in this era of global competition, all organizations must explore new managerial approaches to get an edge in the marketplace. One increasingly appealing approach is outsourcing. Hospitals are particularly fertile environments for outsourcing, given their role as providers of a broad and complex array of services, many of which may be bought from other institutions. The purpose of this study is to determine the types of services that hospitals in Turkey buy from other organizations. The study sample included 14 university hospitals, 20 Ministry of Health Hospitals, 15 Social Insurance Organization Hospitals and 31 private hospitals in Istanbul, Ankara, Izmir, Antalya, and Eskisehir, which are the biggest cities in Turkey. The following services were found to be outsourced: hospital management information systems (83.8%), cleaning services (81.3%), maintenance services (72.5%), leased medical devices (75.0%), food services (60.0%), patient direction services (63.8%), magnetic imaging services (60.0%), other imaging services (48.8%), laboratory services (42.5%), security services (38.8%), laundry services (36.3%), patient transportation services (33.8%), accounting services (26.3%), ambulance services (22.5%), patient satisfaction measurement services (13.8%), consultancy services (12.5%), and financial and investment services (9.5%). Private hospitals bought more services than public facilities did. The sampled hospitals chose to outsource services in order to decrease costs (78.8%), increase the quality of services rendered (65.5%), increase flexibility and share risk (36.6%), and increase profits (11.2%). The results of this study suggest that outsourcing, when applied judiciously through cost and risk analysis, is a cost-effective approach that can be used by most hospitals.
Procedia Economics and Finance, 2014
Outsourcing has shown itself worldwide to be a useful tool for improving partnership between private and public companies. The budgetary constraints imposed by the Italian government on health industry are enhancing the urgency to outsource to face costs. Our study deals with the relationship between ASLs (Aziende Sanitarie Locali, the Italian local health authority) and private operators outsourcing in Italy.