چالش ها و مشکلات پروژه های مشارکت بخش خصوصی و دولتی (PPP) در نظام سلامت: یک مطالعه مروری
سلامت اجتماعی,
دوره 5 شماره 4,
22 November 2018
,
صفحه 386-402
https://doi.org/10.22037/ch.v5i4.19767
چکیده
زمینه و هدف: مدل مشارکت خصومی- دولتی (PPP) اخیرا به عنوان راهکاری برای بهبود کارایی عملکرد و حل کاستی های بهداشتی درمانی دولت ها در حوزه های مختلف معرفی شده است. تعداد مطالعاتی که به صورت نقادانه و از دیدگاه منتقدانه به بررسی این مدل می پردازند بسیار کم است؛ به علاوه هنوز فقدان طبقه بندی مقالات و اجماع ساختاری برای رسیدن به نتایج کاربردی آن ها وجود دارد. در این مطالعه مروری به جمع بندی و دسته بندی این مشکلات می پردازیم.
مواد و روش: این مطالعه به شیوه مروری تدوین شده است؛ جستجو در پایگاه های اطلاعاتی PubMed و Google scholar و SID.ir و Scopus با استفاده از همه ترکیبات دو گروه ذیل انجام شد: گروه یک: "مشارکت خصوصی دولتی"، "همکاری خصوصی دولتی"، "خصوصی سازی"، "ابتکار مالی خصوصی" و مخفف های آن ها و گروه دو: "سلامت"، "بیمارستان"، پس از بررسی های مرحله به مرحله و غربالگری های متناسب، از مجموع 145 مقاله اولیه مورد بررسی تعداد 23 مقاله برای استخراج داده ها استفاده شدند.
يافته ها: مطالعه و بررسی مقالات وارد شده در این مطالعه منتج به شناسایی موارد متعدد پراکنده ای می باشد که بر طبق قرابت مفهومی و دفعات در 13 زیرگروه اصلی مورد طبقه بندی و تفصیل قرار گرفتند: پیچیدگی، ارزیابی و نظارت کیفی ضعیف، نبود شفافیت، عدم هماهنگی کافی، بی توجهی به عدالت و منافع عمومی، نداشتن انعطاف پذیری، کمبود تجربه و دسترسی به دانش اجرایی، منابع ناکافی مالی، نبود ارزیابی صحیح ریسک، عدم مشارکت کافی ذی نفعان، محدودیت انتخاب شریک، عدم توجه به پرسنل
نتيجه گيري: با توجه به نتایج حاصله پیشنهاد می شود توجه طرفین به جزئیات مرحله آغازین و شروع عقد قرارداد بیشتر شود، طرفین به ماهیت، چیدمان و پیچیدگی های این نوع از همکاری ها تا حد امکان اشراف داشته باشند و شفاف سازی کامل و دقیق برای هر دو طرف، مردم و سایر ذی نفعان صورت گیرد.
[e1]چکیده اضافه شود
- نظام سلامت/ همکاری بخش خصوصی دولتی (PPP)
ارجاع به مقاله
مراجع
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