1.11. Modelo de Negocios de Concesiones Hospitalarias

Autores: J. Fernández Labra

Abstract

Intention

This exploratory investigation tries to reach in the identification of key elements for a model of hospitable efficient concession.

Methodology

A bibliographical investigation of the literature is realized considering to be paradigms the application of the model PFI in England and a model more complete that applied in Spain (Model Alzira) who includes in the only system the network of primary care with the hospitable one.

 

Findings:

The current system of concessions presents limitations for the numerous modifications of the contracts (post arragmentopportunism) and feasibility of capture of the controller (capture of the State like hostage) that raise both the original investment and the operational costs spoiling the original cost of the concession; in addition neither the bases nor the contracts demand a definition of the standards of services, There are examined the legal modifications of 2010 that contain dispositions more adapted for soft concessions. One concludes that both biddings effected 2009 present: he delays between preselection and concession (2 years), the bases do not detail standards of service and these matters are left to criterion of the fiscal inspector (financial risk and qualit risk of the service), the medical equipment and the clinical management are left in hands of the State (risk of deterioration as the service for not opportune repair of the equipment).

Future lines of investigation

On flexibility of the contracts of concession, systems of efficient control of modifications of contracts, way of introducing the Criterion of Value of Money VFM in the process of evaluation

Palabras Claves :,Alianza Público Privada, Concesiones Hospitalarias Flexibilidad de contratos, Iniciativa Financiamiento Privado (PFI)

Key Words: Public-Private Partnerships (PPPs), Hospital Concessions Contractual Flexibility, Private Finance Initiative (PFI),