The development of the medical industry: a guide to public-private partnership
Coverage
Lately about public-private partnership (PPP) and mechanisms of its realization does not say except that lazy, but few know and represent what the PPP in medicine, and especially, what kind of projects can be implemented in the health sector, what can be improved and what must be abandoned....
In this article we are not talking about the importance of dissemination of PPPs in the health sector, and not on the regular chanting the merits of private investors who, by investing some cash, consider a narrow provision of expensive medical services, as a great benefit to the state, we talk about the ideal PPP projects in medicine, will explain how should look the interaction between the state and private business in this area and what needs to be done.
Today the meaning of most Cpsni projects in the field of health is that of the entire service, which is integrated with the point of view of technological processes, singled out a particular medical service, as a rule, profitable and a way to recover its costs through kicking OMS investments invested in the construction, reconstruction and equipment of the transferred object.
It turns out that the best projects get under PPP, and all unprofitable costly part falls on the shoulders of the state, i.e. it turns out even worse bias because PPP was meant in another way is the implementation of the project which is due to the capitalization of a project full cycle.
Artificial kidney – a bargaining chip or a real help?
In order to understand how it is now is skewed understanding of PPP in the health sector let us consider the most common variant of interaction between the state and private business in medicine in the entire territory of the Russian Federation – the opening of the hemodialysis centers.
Hemodialysis method extrarenal blood purification on an artificial kidney for patients suffering from chronic renal failure (CRF), which is one of the best, from the point of view of business, medical services.
The definition of CKD stages 3-5 correspond to when patients are narrow specialists such as doctors-nephrologists. When the fifth and final stage of CKD is assigned to dialysis therapy (hemodialysis, artificial kidney).
As we can see, hemodialysis in this chain of treatment, the patient appears only at the fifth stage and is part of Nephrology care, which is only a procedure in the General framework of the fight against chronic kidney disease.
Implementation of the majority of PPP projects on the territory of the Russian Federation on the establishment of hemodialysis centers is carried out only in terms of the provision of the services, and everything else – treat patient round the hospital, diagnostic procedures, arterial-venous fistula, surgical intervention (surgery), stay in intensive care (PETE) as it was, remained in the area of responsibility of the state.
Similarly, the look and other medical services that are actively now get under PPP (MRI, ECHO, diagnostic studies, etc.).
This approach fundamentally is wrong and can't fully talk about the effectiveness of PPP projects in the health sector, because the transfer of the function or industry for which, historically, responsible government, and a full PPP project to be implemented on the principles of mutually beneficial cooperation between the state and private business.
Mission possible
So, as we have already mentioned above, only the implementation of a PPP project full cycle can give a positive effect and are valuable socially oriented project.
Transfer of all forces to one particular service and indifferent attitude to the rest of the treatment of patients leads to the fact that the disease is not detected and patient has treated only the symptoms, not the causes of the disease
The main objective of the partnerships at the expense of timely detection of patients and quality treatment at all stages of disease to smooth out the surge of occurrence for a particular service and carry out comprehensive treatment at earlier stages.
Thus, organizing quality care for all stages of treatment of patients using modern equipment and the latest hardware and software systems not only eliminate risks of tremendous flash treatment of patients for a specific service, but to save a considerable amount of funds OMS, dropping them to other, equally important needs of national health care.
The consequence of this policy will be the decrease of funds on the treatment of one patient. This approach will allow or even negate the risk of the patient for treatment of a particular medical service or, at least, to postpone it indefinitely, and accordingly, to allow longer to be adapted to a normal life.
New trends in health care
A full-fledged PPP project in the health sector is able to take on the entire industry as a whole, fully focusing on all the processes of treatment of the respective disease.
It is the transfer of control of all medical service as a whole, ranging from primary care to high technology, inpatient care, hospital-replacing technologies, intensive care unit, surgery, laboratory diagnostics, telemedicine can provide, as the interests of the state and private business, and comprehensively to provide the patient with quality treatment.
So when does the industry as a whole, i.e. transfer all the efforts of the private partner, even in terms of services, which today are considered nedoplachennie MLA and implemented absolutely free to the public. And should be done all this at the expense of own funds without any investment from the state.
A new concept of PPP in the health sector lies in the fact that entering the region, the investor must provide to the authorities to send him all the way to the movement of the patient from primary physician to specialist care in the daytime, night hospitals, establishment of laboratory services, performing surgical operations, the creation of intensive care.
Of course, such a comprehensive approach, the payback period increases significantly, however, that for such approach the future of PPP in healthcare, it allows the patient to feel all the advantages of this method of providing medical services.
The only way to say that business, acting as a partner of the state not implement a purely commercial project, which after a couple of years will bring him some profit due to the "influx" of patients, and contributes to the harmonization of the social sphere of the region, forming the only true and correct approach to the integrated treatment of patients.
Total
Despite the fact that in recent time the trend of the spread of PPPs is increasingly spans the social sector, including the health sector, the approach of private capital for such projects is often limited to only homogeneous services, which, because of its specific traits are well-funded CBOs and trilostane for public hospitals with TZ. equipment and renovation of premises.
This approach to project implementation is not effective enough, while the greatest interest for the state and patients is a common approach to the provision of medical services – when the industry is not divided on the principle of "owner-state" and corresponds to the same qualitative rules, modern and comfortable.
Such approach is the future of all of medicine in General, and the sooner it will understand the officials responsible for regulating the relevant sector on the ground, the faster the business community will be able to offer qualitatively new and generally useful, approach to project implementation.
To ensure that all stipulated by the legislation procedure was performed properly, so the project was implemented in the most quick and qualitative way You can not do without skilled consultants who in my experience can not only accompany the project at the stage of negotiations and prepare all necessary for the implementation of the agreement documents, but also at a decent level to help in the further implementation of the project.