PUBLIC-PRIVATE LACE IN HEALTH CARE: QUALITY, SUSTAINABILITY AND CHANGES OF THE SPANISH MODEL (Q3136845)

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Project Q3136845 in Spain
Language Label Description Also known as
English
PUBLIC-PRIVATE LACE IN HEALTH CARE: QUALITY, SUSTAINABILITY AND CHANGES OF THE SPANISH MODEL
Project Q3136845 in Spain

    Statements

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    27,769.5 Euro
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    32,670.0 Euro
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    85.0 percent
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    1 January 2018
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    31 December 2021
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    UNIVERSIDAD DE LAS PALMAS DE GRAN CANARIA
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    35016
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    EL PROYECTO APORTARA UNA BASE SOLIDA DE CONOCIMIENTO PARA LA TOMA DE DECISIONES SOBRE COLABORACION CON ENTIDADES PRIVADAS POR PARTE DEL SNS, Y EVALUARA LAS CONSECUENCIAS PREVISIBLES DE UN HIPOTETICO CAMBIO DE ¿MODELO¿ DE ENCAJE PUBLICO-PRIVADO EN LA SANIDAD ESPAÑOLA._x000D_ LA COLABORACION PUBLICO-PRIVADA EN SANIDAD ES CONTROVERTIDA. LA EVALUACION DE EXPERIENCIAS EN PAISES CON DISTINTOS SISTEMAS DE SALUD LLAMA A LA PRECAUCION Y PONE ENFASIS EN LA IMPORTANCIA DEL DISEÑO ADECUADO DE LOS CONTRATOS. EL SUBPROYECTO CONTRIBUIRA A CLARIFICAR LAS CONDICIONES BAJO LAS CUALES LAS GARANTIAS DE BIENESTAR SOCIAL QUEDEN MEJOR PRESERVADAS Y SE MINIMICE LA INCERTIDUMBRE SOBRE LA SOSTENIBILIDAD DEL SNS. _x000D_ _x000D_ ¿QUE TIPOS DE COLABORACION PUBLICO-PRIVADA SON MAS CONVENIENTES Y QUE MECANSIMOS DE CONTROL HAN DE ESTABLECERSE EN LOS CONTRATOS? ¿HAY EVIDENCIA EMPIRICA DE QUE LA PRESTACION POR PROVEEDORES PRIVADOS BAJO FORMULAS DE COLABORACION SEA MAS EFICIENTE?¿COMO SE CARACTERIZA LA DEMANDA DE SERVICIOS PRIVADOS BAJO DISTINTAS FORMAS DE ASEGURAMIENTO? ¿CUALES SON LAS EXPECTATIVAS RACIONALES DE RENDIMIENTO ECONOMICO-FINANCIERO DE LOS OPERADORES PRIVADOS EN ESPAÑA, Y SU COMPORTAMIENTO ESPERADO EN CUANTO A CONCERTACION?. AUNQUE HA HABIDO EXPERIENCIAS MUY INNOVADORAS DE GESTION INDIRECTA DE LA SANIDAD EN ESPAÑA, ESTAN INSUFICIENTEMENTE EVALUADAS Y EL DEBATE SOCIAL ESTA MUY IDEOLOGIZADO. _x000D_ _x000D_ HIPOTESIS_x000D_ _x000D_ 1. LAS EXPERIENCIAS INTERNACIONALES DE GESTION INDIRECTA DE LA SANIDAD PRESENTAN RESULTADOS HETEROGENEOS DEPENDIENDO DEL CONTEXTO, DEL DISEÑO DE LOS CONTRATOS Y DE SU IMPLEMENTACION_x000D_ 2. LA DEMANDA DE ASEGURAMIENTO PRIVADO ES DE ALTA ELASTICIDAD RENTA Y HA EXPERIMENTADO CAMBIOS RELEVANTES CON LA CRISIS ECONOMICA_x000D_ 3. LOS DETERMINANTES DE LA ELECCION DE ASEGURADORA DENTRO DE MUFACE PUEDEN ESTIMARSE CON MICRODATOS DE LAS ENTIDADES PARA INFORMAR SOBRE LAS CONSECUENCIAS DE UN EVENTUAL CAMBIO DE ¿MODELO¿ SANITARIO EN ESPAÑA_x000D_ 4. NO HAY DIFERENCIA SISTEMATICA DE CALIDAD CLINICA O EFICIENCIA PRODUCTIVA ENTRE CENTROS SANITARIOS DEL SNS CON DISTINTAS FORMAS DE GESTION _x000D_ 5. LA COLABORACION PUBLICO- PRIVADA REPRESENTA UN FUERTE INCENTIVO PARA LAS EMPRESAS OPERADORAS DEL SECTOR PRIVADO LUCRATIVO, EN TERMINOS DE EXPECTATIVAS DE RENTABILIDAD_x000D_ _x000D_ OBJETIVOS ESPECIFICOS: _x000D_ 1. CONCEPTUALIZAR Y REVISAR EXPERIENCIAS INTERNACIONALES DE ESQUEMAS DE COLABORACION PUBLICO-PRIVADA EN SANIDAD_x000D_ 2. FORMULAR PROPUESTAS FUNDADAS DE DISEÑOS DE CONTRATOS ENTRE ADMINISTRACIONES PUBLICAS Y ORGANIZACIONES SANITARIAS PRIVADAS PARA ESPAÑA_x000D_ 3. ANALISIS DE LA DEMANDA DE ASEGURAMIENTO SANITARIO PRIVADO Y DE LA UTILIZACION DE ASISTENCIA SANITARIA PRIVADA EN ESPAÑA. _x000D_ 4. ESTIMACION EMPIRICA DE LA EFICIENCIA Y CALIDAD COMPARADAS DE LOS CENTROS SANITARIOS PUBLICOS Y PRIVADOS EN ESPAÑA 2005-2015 SEGUN MODELOS DE GESTION_x000D_ 5. ANALIZAR LOS INCENTIVOS A LA COLABORACION PUBLICO-PRIVADA DESDE LA PERSPECTIVA DE LAS EXPECTTIVAS DE NEGOCIO DEL SECTOR PRIVADO LUCRATIVO_x000D_ _x000D_ BAJO EL MARCO ANALITICO DE LA TEORIA DE LOS CONTRATOS INCOMPLETOS SE ANALIZARAN LOS EFECTOS DE LOS INCENTIVOS MONETARIOS Y FORMULAS DE PAGO Y SE PROPONDRA COMO OPTIMIZAR LOS CONTRATOS DE COLABORACION PUBLICO-PRIVADA. _x000D_ _x000D_ CON VARIAS BASES DE MICRODATOS SE MODELIZARA LA DEMANDA Y UTILIZACION DE SERVICIOS SANITARIOS PRIVADOS Y LA EFICIENCIA PRODUCTIVA DE LOS CENTROS SEGUN MODELO DE GESTION, ASI COMO LOS INCENTIVOS ECONOMICO-FINANCIEROS DE LAS ORGANIZACIONES PRIVADAS LUCRATIVAS A LA COLABORACION CON EL SECTOR PUBLICO. SE UTILIZARAN METODOS ECONOMETRICOS Y BIG DATA. (Spanish)
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    THE PROJECT WILL PROVIDE A SOLID BASE OF KNOWLEDGE FOR DECISION-MAKING ON SERVICE-PROVISION AGREEMENTS BETWEEN THE SPANISH NATIONAL HEALTH SERVICE AND PRIVATE ENTITIES, AND WILL EVALUATE THE FORESEEABLE CONSEQUENCES OF A HYPOTHETICAL CHANGE OF MODEL FOR PUBLIC-PRIVATE FIT WITHIN THE SPANISH HEALTH SYSTEM._x000D_ PUBLIC-PRIVATE COLLABORATION IN HEALTH IS A CONTROVERSIAL QUESTION. THE EVALUATION OF EXPERIENCES IN COUNTRIES WITH DIFFERENT HEALTH SYSTEMS HIGHLIGHTS THE NEED FOR CAUTION AND EMPHASISES THE IMPORTANCE OF GOOD CONTRACT DESIGN. THE SUBPROJECT WILL HELP CLARIFY THE CONDITIONS UNDER WHICH SOCIAL WELFARE GUARANTEES ARE BEST PRESERVED AND MINIMISE UNCERTAINTY ABOUT THE SUSTAINABILITY OF THE NHS._x000D_ THE PROJECT WILL ADDRESS THE FOLLOWING QUESTIONS. WHAT TYPES OF PUBLIC-PRIVATE PARTNERSHIPS ARE MOST DESIRABLE AND WHAT CONTROL MECHANISMS SHOULD BE ESTABLISHED IN SUCH CONTRACTS? IS THERE EMPIRICAL EVIDENCE THAT PROVISION IS MORE EFFICIENT BY PRIVATE PROVIDERS UNDER COLLABORATIVE FORMULAS? HOW IS DEMAND FOR PRIVATE SERVICES CHARACTERISED UNDER DIFFERENT FORMS OF INSURANCE? WHAT ARE THE RATIONAL EXPECTATIONS OF ECONOMIC-FINANCIAL PERFORMANCE OF PRIVATE OPERATORS IN SPAIN? HOW ARE THEY EXPECTED TO BEHAVE REGARDING PUBLIC-PRIVATE COLLABORATION? ALTHOUGH THERE HAVE BEEN INNOVATIVE EXPERIENCES OF INDIRECT MANAGEMENT OF HEALTH SERVICES, THEY HAVE NOT BEEN EVALUATED IN DEPTH._x000D_ HYPOTHESES _x000D_ 1.INTERNATIONAL EXPERIENCES OF INDIRECT HEALTH MANAGEMENT HAVE PRODUCED MIXED RESULTS, DEPENDING ON THE CONTEXT AND ON CONTRACT DESIGN AND IMPLEMENTATION._x000D_ 2.THE DEMAND FOR PRIVATE INSURANCE FEATURES HIGH INCOME ELASTICITY AND UNDERWENT SIGNIFICANT CHANGES DURING THE ECONOMIC CRISIS._x000D_ 3.THE DETERMINANTS OF THE CHOICE OF INSURER WITHIN MUFACE CAN BE ESTIMATED WITH MICRODATA FROM THE COMPANIES AND USED TO ASSESS THE CONSEQUENCES OF A POSSIBLE CHANGE OF MODEL FOR HEALTH SERVICES IN SPAIN._x000D_ 4.THERE IS NO SYSTEMATIC DIFFERENCE IN CLINICAL QUALITY OR PRODUCTIVE EFFICIENCY BETWEEN SNS HEALTH CENTRES ACCORDING TO THE TYPE OF MANAGEMENT ADOPTED._x000D_ 5.PUBLIC-PRIVATE COLLABORATION IS AN ATTRACTIVE PROPOSITION FOR COMPANIES OPERATING IN THE FOR-PROFIT PRIVATE SECTOR, IN TERMS OF PROFITABILITY EXPECTATIONS._x000D_ SPECIFIC AIMS:_x000D_ 1.TO CONCEPTUALISE AND REVIEW INTERNATIONAL EXPERIENCES OF PUBLIC-PRIVATE PARTNERSHIP SCHEMES IN HEALTH SERVICE PROVISION._x000D_ 2.TO FORMULATE WELL-FOUNDED CONTRACT DESIGN PROPOSALS FOR COLLABORATIONS BETWEEN PUBLIC ADMINISTRATIONS AND PRIVATE HEALTH ORGANISATIONS IN SPAIN._x000D_ 3.TO ANALYSE THE DEMAND FOR PRIVATE HEALTH INSURANCE AND THE USE OF PRIVATE HEALTH CARE IN SPAIN._x000D_ 4.TO EMPIRICALLY ASSESS THE COMPARATIVE EFFICIENCY AND QUALITY OF PUBLIC AND PRIVATE HEALTH CENTRES IN SPAIN IN THE PERIOD 2005-2015, ACCORDING TO THE MANAGEMENT MODEL ADOPTED._x000D_ 5.TO ANALYSE THE INCENTIVES FOR PUBLIC-PRIVATE COLLABORATION FROM THE PERSPECTIVE OF PRIVATE SECTOR BUSINESS EXPECTATIONS._x000D_ WITHIN THE FRAMEWORK OF THE THEORY OF INCOMPLETE CONTRACTS, THE EFFECTS OF MONETARY INCENTIVES AND PAYMENT FORMULAS WILL BE ANALYSED AND PROPOSALS MADE ON OPTIMIZATION OF PUBLIC-PRIVATE PARTNERSHIP CONTRACTS._x000D_ MICRODATA DATABASES WILL BE USED TO MODEL THE DEMAND AND UTILIZATION FOR PRIVATE HEALTH SERVICES, AND THE PRODUCTIVE EFFICIENCY OF THE CENTRES, ACCORDING TO THE MANAGEMENT MODEL ADOPTED.IN ADDITION, THE ECONOMIC AND FINANCIAL INCENTIVES TO FOR-PROFIT ORGANISATIONS TO COLLABORATE WITH THE PUBLIC SECTOR WILL BE CONSIDERED. ECONOMETRIC METHODS AND BIG DATA WILL BE USED. (English)
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    Palmas de Gran Canaria, Las
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    Identifiers

    ECO2017-83771-C3-2-R
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