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The purpose of the paper is to describe and analyze differences in patients' quality perceptions of private and public primary care centers in Sweden.

The article explores the differences in quality perceptions between patients of public and private primary care centers based on data from a large patient survey in Sweden. The survey covers seven dimensions, and in this paper the measure Overall impression was used for the comparison. With more than 80,000 valid responses, the survey covers all primary care centers in Sweden which allowed for a detailed analysis of differences in quality perceptions among patients from the different categories of owners.

The article contributes with a detailed description of different types of private owners: not-for-profit and for profit, as well as corporate groups and independent care centers. The results show a higher quality perception for independent centers compared to both public and corporate groups.

The small number of not-for-profit centers (21 out of 1,117 centers) does not allow for clear conclusions for this group. The results, however, indicate an even higher patient quality perception for not-for-profit centers. The study focus on describing differences in quality perceptions between the owner categories. Future research can contribute with explanations to why independent care centers receive higher patient satisfaction.

The results from the study have policy implications both in a Swedish as well as international perspective. The differentiation between different types of private owners made in this paper opens up for interesting discussions on privatization of healthcare and how it affects patient satisfaction.

The main contribution of the paper is the detailed comparison of different categories of private owners and the public owners.

The objective is to explore how the professionalisation of care jobs is constructed in the public and private sectors and to discuss whether the instruments used by public and private care providers contribute to solve the ambiguities linked to this type of work and which are the consequences for caregivers.

This paper compares the way in which the professionalisation of home care services for elderly people is achieved in the public and private sectors in the region of Brussels. The findings are based on the analysis of interviews with professional actors working in the care sector in Brussels.

The analysis shows that there is no agreement over the best way of professionalising home care services for the elderly and that the efforts made by public and private providers are profoundly different.

The divergencies are not only the result of the strict institutional framework to which public care providers are bound, in opposition to the relative freedom of the private sector, but they also derive from a different understanding of care work.

The purpose of this paper is to compare home care workers' views of their employment conditions by provider type – private for-profit vs public and non-profit – using the case study of Ireland.

An online survey was distributed to care workers (n = 350) employed by private for-profit, public and non-profit home care providers in Ireland. Returned questionnaires were analysed statistically in R using chi-squared tests to systematically compare key aspects of employment conditions.

Analysis shows that conditions are perceived to be significantly worse for those employed by private for-profit providers (and to a lesser extent non-profit organisations) compared to the public provider. There are wide disparities between public and private sector conditions in terms of contracts, pensions, unsocial hours pay and travel time allowances. The main area of convergence is in relation to employer support, where although the public sector performed better, the difference between the three provider types is smaller.

Relatively little research compares working conditions in private for-profit providers vs public and non-profit providers in Ireland and other countries. The findings can be understood in the context of marketisation reforms and may partly be explained by a lack of regulation in Ireland's home care sector and low unionisation rates amongst care workers employed by private for-profit providers.

Social and economic trends toward local governance form the context for health and mental health policy and the reorganization of care systems for cost-containment in the United States. Local management of public–private collaborations is promoted by state agencies as a means of rationalizing mental health care and community support services. This chapter analyses the local process of developing public–private partnerships for mental health care, based on an ethnographic case study of county Mental Health/Mental Retardation and behavioral health committees and coalitions in Texas, from 1995 to 2001. Following this period, local service agencies continued collaboration to increase community awareness and resources for care. Findings were that while the rapid transition to local control under conditions of reduced resources impeded implementation of a public–private mental health care system, commitment to a service safety net for persons with mental disabilities was sustained.

The central lesson to be learned from studying the case is to understand the challenges and constraints posed by contextual conditions in designing contracts in public–private partnerships (PPP) for financing and delivering health care in emerging economies such as India.

Perverse incentives, along with contextual conditions, led to extensive opportunistic behaviors among involved agencies, limiting the effectiveness of otherwise highly regarded innovative design of the program.

India’s “Rashtriya Swasthya Bima Yojana” or National Health Insurance Program, launched in 2007 provided free health insurance coverage to protect millions of low-income families from getting pushed into poverty due to catastrophic health-care expenditure. The program was implemented through a PPP using standardized contracts between multiple stakeholders from the public and private sector – insurance companies, hospitals, intermediaries, the provincial and federal government.

Teaching Notes are available for educators only.

CSS: 10 Public Sector Management.

This case study aims to introduce a novel home care service integrator model called “Kotitori”. In the model the City contracts with a private provider, which, in turn, works with public, private, and third sector providers in order to meet the customer needs in a personalised way.

The case study draws from key policy documents and stakeholder interviews.

The study introduces a unique form of public‐private partnership in Finland, and describes the basic elements of Kotitori, the development process of the model, and the model's distinctive features compared to more traditional ways of home care service delivery.

The Kotitori model is still in its early stages of implementation and reliable data on performance are limited.

The transferability potential of the Kotitori model is good both nationally and internationally. The model is potentially beneficial for countries with an interest in developing integrated care in general, as it reflects a form of “accountable care organisation”.

This is the first study describing the Kotitori model for an international audience.

This paper seeks to address the question, “How can private home care providers compete and drive their businesses forward to deliver best value to the community?” Public sector managers in local authorities need this question answered so that they can provide their part of the solution, facilitating best value.

A review was performed of relevant literature on the commissioning (outsourcing) of home care and of best value. This indicates that the future of home care services, taking into consideration commissioning and how best value will be achieved, has not been researched widely. Therefore, an exploratory approach to research was adopted here using in‐depth analysis of a small number of particularly informative local authorities and private providers selected by purposive/judgemental (extreme and critical case) sampling. Personal contact was deemed necessary in order to perform an intensive investigation to pursue in‐depth information.

To improve value one can cut costs and/or increase quality. It is argued here that there is little immediate opportunity for private home care providers to cut costs and with fixed pricing substantial improvements in quality cannot be funded by increased prices or cost cutting elsewhere. To address this impasse, two solutions have been identified; increased economies of scale through consolidation in the marketplace and radical improvements in efficiency through the exploitation of information and communication technology (ICT). Both of these strategies have major ramifications for the “enabling local authority” taking actions to see best value delivered to its community.

This paper presents the findings of exploratory research. A more detailed study covering many more local authorities, private care providers and an international prospective will be conducted over the next two years.

This paper provides timely guidance to public sector managers in local authorities and private home care providers seeking best value in home care through commissioning.

Little has been found in the literature on strategies by which private home care providers can deliver best value, yet such strategies are needed urgently to achieve best value. This paper is a timely contribution to addressing this need.

The research analyzes good practices in health care “management experimentation models,” which fall within the broader range of the integrative public–private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the “management experimentation models” are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations.

In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC – Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies.

The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable.

The recognition of ISMETT’s good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

This paper describes the methodology of a PhD thesis that was a study of the regulatory practices in the private health care sector of Bangladesh. The paper begins by situating the methodology in the nature, context and significance of the study. As the study involved a policy analysis and evaluation these are defined and described. The paper concentrates on the research design and methodology, which involved the use of qualitative methods. The sampling is described and the methods used included in‐depth interviews, the taking of field notes based on observations and document analysis. Attention is also given to ethical issues. The problems that emerged and the limitations of the study design and methodology are also discussed.

Health is a fundamental populations’ need and an integral part of the socio-economic development of a country. However, it is required to explain the growing role of the private sectors in addressing various health care needs. The purpose of this paper is to analyse potential contribution, criticalities and conditions of success of public-private partnership (PPP) as a strategy to face the complexity of nationally relevant Italian and Indian service systems.

The methodology is built upon the basis of the viable systems approach (VSA) integrated with the fundamental interpretative elements of service science and service-dominant logic to contextualize interpretation to the management of service systems benefitting from recent advances in these research fields.

A VSA-based general framework of reference is built that is useful for analysing any relational context in which different aims and expectations need to be harmonized to make the collaboration effective. On the basis of this framework, first insights on Italian and Indian health care PPPs are proposed, highlighting key elements of analysis and criticalities that may challenge a positive conclusion on health care PPPs.

The implications of the study are both theoretical and practical. From a theoretical perspective, the study contributes to the scholarly understanding of complex health care system in Italy as well as in India with particular reference to the public-private collaboration phenomenon. It also suggests theoretical approaches in the form of a generic VSA-based framework as applicable. From a practical perspective, the study stimulates managers to a critical reflection about current health care management approaches which are reflected in the adoption of PPPs solutions.

The paper discusses relevant worldwide decision-making challenges, such as the equality in the populations’ access to health service, suggesting managers the way to create conditions of consonance among the diverse stakeholders for a successful health care PPPs.