International Health Care Management
Part 3b
Steffen Fleßa
Institute of Health Care Management University of Greifswald
Supply of Health Services: Structure
1 International Public Health 2 Demand for Health Services 3 Supply of Health Services
3.1 Factors of Production
3.2 Spatial Structure of Supply 3.3 Levels of Care
3.4 Provider Portfolio 4 Health Reforms
3.4 Provider Portfolio
• Trustee:
– Public
• federal
• provincial
• districts
– Nonprofit – Commercial
• Who should supply what on what level?
• How should collaboration look like?
Provider Portfolio
Organizations
For-Profit Org. Non-Profit Org.
Governmental NPOs Economic
NPO Socio-
cultural NPO Political
NPO Charitable
NPO
Private Organizations
Church Social Work
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CSO i.n.s.
Civil Society Organisations i.b.s.
NPOs
• NPO: limitations to allocations of profits
• CSO in a broader sense: collective term for charitable, political as well as socio-cultural NPOs.
• CSO in a narrower sense: civil society’s participation in political decision making (Advocacy). Political NPO
Collaboration of Providers
Serengeti
Haydom
Iambi
Dongobesh
Mbulu Lutheran Hospital
Government Hospital
Lutheran Dispensary Government Dispensary
Supervision?
Serengeti
Haydom
Iambi
Dongobesh
Mbulu Lutheran Hospital
Government Hospital
Lutheran Dispensary Government Dispensary
Public-Private Partnership (PPP)
• Assumption: there are public goods the state has to provide
– Not Pareto optimal
– Insufficient provision of certain (poverty) groups
• But: This does not imply the state operating as financer
• The state can collaborate with the private economy regarding the provision of public goods
PPP: Deviating Criteria
• Exclusive partnership of state with commercial businesses vs. additionally partnering with
• NPOsPartnership via market regulation (through prices) vs. partnerships based on long-term contracts and agreements
• Partnering with non-governmental
organizations performing public tasks vs.
participation of the private economy in public production (i.e. financing public hospitals via
PPP - Versions
Supply of Health Services: Structure
1 International Public Health 2 Demand for Health Services 3 Supply of Health Services
3.1 Factors of Production
3.2 Spatial Structure of Supply 3.3 Levels of Care
3.4 Provider Portfolio 4 Health Reforms
