title: Does ownership matter? An overview of systematic reviews of the performance of private for-profit, private not-for-profit and public healthcare providers.
abstract: BACKGROUND
  Ownership of healthcare providers has been considered as one factor that might influence their health and healthcare related performance. The aim of this article was to provide an overview of what is known about the effects on economic, administrative and health related outcomes of different types of ownership of healthcare providers--namely public, private non-for-profit (PNFP) and private for-profit (PFP)--based on the findings of systematic reviews (SR).
  
  
  RESULTS
  An overview of systematic reviews was performed. Different databases were searched in order to select SRs according to an explicit comprehensive criterion. Included SRs were assessed to determine their methodological quality. Of the 5918 references reviewed, fifteen SR were included, but six of them were rated as having major limitations, so they weren't incorporated in the analyses. According to the nine analyzed SR, ownership does seem to have an effect on health and healthcare related outcomes. In the comparison of PFP and PNFP providers, significant differences in terms of mortality of patients and payments to facilities have been found, both being higher in PFP facilities. In terms of quality and economic indicators such as efficiency, there are no concluding results. When comparing PNFP and public providers, as well as for PFP and public providers, no clear differences were found.
  
  
  CONCLUSIONS
  PFP providers seem to have worst results than their PNFP counterparts, but there are still important evidence gaps in the literature that needs to be covered, including the comparison between public and both PFP and PNFP providers. More research is needed in low and middle income countries to understand the impact on and development of healthcare delivery systems.
authors.affiliation: Department of Public Health, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Evidence Based Health Care Program, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Cristian A
authors.initials: CA
authors.lastname: Herrera
authors.affiliation: Evidence Based Health Care Program, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Internal Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rada
authors.affiliation: Evidence Based Health Care Program, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; National Health Technology Assessment Commission, Ministry of Health Chile, Santiago, Chile.
authors.forename: Lucy
authors.initials: L
authors.lastname: Kuhn-Barrientos
authors.affiliation: Department of Public Health, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Evidence Based Health Care Program, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Ximena
authors.initials: X
authors.lastname: Barrios
mesh_terms: D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration; D006269:Health Facilities, Proprietary / Q000191:economics* / Q000458:organization & administration; D006282:Health Personnel / Q000191:economics* / Q000458:organization & administration; D016304:Hospitals, Private / Q000191:economics / Q000458:organization & administration; D006801:Humans; D009939:Organizations, Nonprofit / Q000191:economics* / Q000458:organization & administration; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration