Public-private partnership in the healthcare system of Khabarovsk Krai
Authors:   Far Eastern Institute of Management – branch of the Russian Academy of National Economy and Public Administration under the President of the Russian Federation, Khabarovsk, Russia, Veselov A.V. , Nikonov E.N. ,   Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Moscow, Russia, Maslyuk N.A. ,   Far Eastern Institute of Management – branch of the Russian Academy of National Economy and Public Administration under the President of the Russian Federation, Khabarovsk, Russia, Chugai D.V. , Gorelov M. V. ,   Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Moscow, Russia, Makhmutov A. A. ,   M. I. Shevchuk City Hospital of the Ministry of Health of the Khabarovsk Krai, Komsomolsk-on-Amur, Russia
Published: December 2023

Relevance The tasks set for the healthcare system require the attraction of significant resources, primarily financial ones. Public-private partnership (hereinafter referred to as PPP) can become an effective tool for solving some of the tasks set, attract investments and become a serious inductor in the implementation of infrastructure projects, the construction of modern medical organizations. Some forms of PPP may make it possible to raise additional funds for the provision of medical care and the expansion of paid medical services. All this requires a more detailed scientific study of the forms of interaction between PPPs in the healthcare sector. Purpose and objectives of the study The purpose of the study is to increase the effectiveness of interaction between the state and business in the health care of Khabarovsk Krai by developing a set of measures using public-private partnership tools. The objectives of the study included the study of publications and the legal framework, the structure of financing in the system of compulsory health insurance, the study of the level of awareness and willingness to involve healthcare organizers of medical organizations in Khabarovsk Krai in PPP processes, as well as the study of infrastructure facilities subordinate to the Ministry of Health of Khabarovsk Krai. Materials and methods The study used data from open sources, including regulatory legal acts, publications and articles on PPP issues, studied open data from the territorial fund of compulsory medical insurance of Khabarovsk Krai, data from the unified state register of real estate. Also, a survey of health care organizers was conducted using a questionnaire specially designed for the study. Results A classification of public-private partnerships in healthcare has been developed, and the main forms of interaction have been identified. It was determined that from 2020 to 2022, funding for non-state medical organizations increased by 15 %: from 1.001.741.1 thousand rubles to 1.151.886.0 thousand rubles. There is a predominance of funding, including in 2022, of organizations of the Russian Railways system (627.552.0 thousand rubles), as well as organizations providing hemodialysis services (195.913.0 thousand rubles) and radiation diagnostics (219. 265.0 thousand rubles) PPP forms are actively used to solve social problems under the “Older Generation” program, funding for ophthalmology has been significantly increased, the dynamics compared to 2020 is +1975 %. According to the results of a survey of healthcare organizers, 2/3 of the respondents see development prospects, 44 % consider outsourcing to be the most promising, 26 % – concession agreements, 92 % indicate an insufficient level of awareness on PPP issues, 90 % expressed their willingness to take part in educational events. In total, the subordinate organizations of the Ministry of Health of Khabarovsk Krai have 1.369 premises and buildings, 419 (30.1 %) of them are used to provide the main function of medical organizations, and 950 are auxiliary. 187 (44.6 %) out of 419 have over 80 % wear and tear, need either reconstruction, major repairs, or are subject to demolition and construction of new facilities. Conclusion The results of the study allow us to fix the main parameters of the healthcare industry, determine ways for further improvement, and develop a set of measures for the development of public-private partnerships in healthcare. It is necessary to conduct an in-depth scientific study of PPP with the involvement of economists, specialists in the field of state and municipal administration, healthcare organizers, undergraduates and graduate students. A comprehensive comprehensive study will significantly increase the effectiveness of measures to develop public-private partnerships in Khabarovsk Krai.