Public Hospital Facilities Development Using Build-Operate-Transfer Approach: Policy Consideration for Developing Countries
نویسندگان
1 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran
2 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran
3 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran
4 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran
doi
چکیده
Background: Advantages and limitations of build-operate-transfer (BOT) contracts in various forms of public-private partnership(PPP) arrangements have not been studied.Objectives: This study is the first of its kind to determine the framework, advantages, and limitations of BOT contracts for healthcare projects in selected countries.Methods: A comparative design was employed to identify factors affecting the development of medical facilities through the adoptionof PPPs and the implementation of BOT contracts. England, Spain, Australia, Turkey, and Canada were selected, and data weregathered through well-known databases for the relevant studies. Electronic databases were searched using the keyword terms,“build-operate-transfer,” “public-private partnerships,” “health sector/health system,” “health care facilities,” “Spain,” “Canada,”“England or United Kingdom,” “Turkey,” and “Australia.”Results: The findings revealed that while there was insufficient information transparency for adoption of the BOT contract model indeveloping medical facilities and building new hospitals, some similarities were observed in its adoption in public fields. Adoptionof the BOT contract model has been proven feasible in the selected countries for the health sector, in particular, for the developmentof new hospitals. These contracts are usually long-term in nature to provide the private sector with the chance to appropriatelyexploit the field. Different countries utilize this model to meet public regional and long-term health care needs, where the goal isnot just a matter of seeking the private sector’s contribution.Conclusions: This study suggests that more information transparency is required for these types of contracts. Factors such as theterm of the contract, the maintenance of the facilities built andtheir post-completion ownership status, facilities and credits offeredto the private sector during the construction and operation phases, and the provision of financial and non-financial incentives tothe private sector require deeper examination and should also be adjusted to the local contexts of the developing country.
