Can Public-Private Partnerships Foster Investment Sustainability in Smart Hospitals?

Abstract

This article addresses the relationship between Public-Private Partnerships (PPP) and the sustainability of public spending in smart hospitals. Smart (technological) hospitals represent long-termed investments where public and private players interact with banking institutions and eventually patients, to satisfy a core welfare need. Characteristics of smart hospitals are critically examined, together with private actors’ involvement and flexible forms of remuneration. Technology-driven smart hospitals are so complicated that they may require sophisticated PPP. Public players lack innovative skills, whereas private actors seek additional compensation for their non-routine efforts and higher risk. PPP represents a feasible framework, especially if linked to Project Financing (PF) investment patterns. Whereas the social impact of healthcare investments seems evident, their financial coverage raises growing concern in a capital rationing context where shrinking public resources must cope with the growing needs of chronic elder patients. Results-Based Financing (RBF) is a pay-by-result methodology that softens traditional PPP criticalities as availability payment sustainability or risk transfer compensation. Waste of public money can consequently be reduced, and private bankability improved. In this study, we examine why and how advanced Information Technology (IT) solutions implemented in “Smart Hospitals” should produce a positive social impact by increasing at the same time health sustainability and quality of care. Patient-centered smart hospitals realized through PPP schemes, reshape traditional healthcare supply chains with savings and efficiency gains that improve timeliness and execution of care.

Healthcare Digitalization and Pay-For-Performance Incentives in Smart Hospital Project Financing

“…The analogic extension of this template to other cases is possible, as illustrated in the discussion. Whereas the interpretation of smart healthcare PPP investments [6,16,19] should adequately incorporate the (hardly predictable) impact of digital innovation, other industries require a preliminary definition of their business model and supply chain bottlenecks, considering the base case and the digital upgrade. This does not seem an easy task.…”

“…The introduction of health information technologies (HIT) increases organizational performance, including productivity enhancement and cost reductions. HIT can contribute to hospital profitability, for instance, by reducing paper chart pulling and document transportation, reducing medical errors, and potentially lowering medical liability costs as well as decreasing back-office expenses [18,19]. These technological advances hence contribute to making the model sustainable and profitable for all the stakeholders.Consistent with this evolving framework, this paper will concentrate on some key aspects that concern the digital impact on infrastructural healthcare investments that face increasing public budget pressures.…”

Visitor-Sensing: Involving the Crowd in Cultural Heritage Organizations

“…Visitors who actively participate to the management of cultural heritage organizations will also be, per se, more satisfied in that they contribute to a public good, and this increased satisfaction may encourage them to further visit the museum and to engage in positive word of mouth referrals. All this will translate into greater numbers of visitors, with positive impacts on both the economic sustainability of museums, in terms of increased revenues, and their social sustainability, in terms of a wider audience reached and increased literacy of citizens, which are two crucial aspect of the sustainability tripod to which organizations are increasingly paying attention [27,[79][80][81][82][83][84][85][86][87]. The above-mentioned issues are relevant issues for both cultural heritage organizations and policymakers [28,56], thereby benefiting simultaneously the two logics which characterize hybrid organizations [55,88].…”

The Spatial Dimension of Income Inequality: An Analysis at Municipal Level

“…In the direction of restoring centrality to territorial specificities as a distinctive element of the policy action, the Lisbon Agenda and, subsequently, the Strategy 2020 updated the analysis of the convergence processes of economic development in Europe. However, as some scholars point out [9,22], it is necessary to seek integration between the so-called people-based policies, related to mobility, to healthy [88], to education, and to the so-called place-based ones [13] connected to employment, particularly focusing on the diffusion of knowledge, to innovation, and to a place-sensitive perspective [22], which combines an individual perspective with a territorial one to face the multiple development trajectories [89].…”