title: A Public-Private Partnership Improves Clinical Performance In A Hospital Network In Lesotho.
abstract: Health care public-private partnerships (PPPs) between a government and the private sector are based on a business model that aims to leverage private-sector expertise to improve clinical performance in hospitals and other health facilities. Although the financial implications of such partnerships have been analyzed, few studies have examined the partnerships' impact on clinical performance outcomes. Using quantitative measures that reflected capacity, utilization, clinical quality, and patient outcomes, we compared a government-managed hospital network in Lesotho, Africa, and the new PPP-managed hospital network that replaced it. In addition, we used key informant interviews to help explain differences in performance. We found that the PPP-managed network delivered more and higher-quality services and achieved significant gains in clinical outcomes, compared to the government-managed network. We conclude that health care public-private partnerships may improve hospital performance in developing countries and that changes in management and leadership practices might account for differences in clinical outcomes.
authors.affiliation: Nathalie McIntosh (mcintnm@gmail.com) is a health services researcher at the Veterans Affairs (VA) Boston Healthcare System, in Massachusetts.
authors.forename: Nathalie
authors.initials: N
authors.lastname: McIntosh
authors.affiliation: Aria Grabowski is a research assistant at the ebola for ONE campaign, in Washington, D.C. At the time this study was conducted, she was a research assistant at the Center for Global Health and Development, Boston University, in Massachusetts.
authors.forename: Aria
authors.initials: A
authors.lastname: Grabowski
authors.affiliation: Brian Jack is a professor in and chair of the Department of Family Medicine at Boston University.
authors.forename: Brian
authors.initials: B
authors.lastname: Jack
authors.affiliation: Elizabeth Limakatso Nkabane-Nkholongo is country director at the Lesotho Boston Health Alliance, in Maseru.
authors.forename: Elizabeth Limakatso
authors.initials: EL
authors.lastname: Nkabane-Nkholongo
authors.affiliation: Taryn Vian is an associate professor of global health at the Center for Global Health and Development, Boston University.
authors.forename: Taryn
authors.initials: T
authors.lastname: Vian
mesh_terms: D002983:Clinical Competence; D003695:Delivery of Health Care; D006076:Government; D006779:Hospitals, Public; D006801:Humans; D007927:Lesotho; D055818:Public-Private Sector Partnerships / Q000458:organization & administration*; D058996:Quality Improvement
keywords: Business Of Health; Developing World < International/global health studies; Financing Health Care; Hospitals; Quality Of Care