مطالعه تطبیقی خصوصی سازی با روش عقد قرارداد برای ارائه مراقبت های سلامتی در کشورهای منتخب و ارائه الگوی مناسب برای ایران

 Introduction: Considering the advantages and disadvantages of health care provision in both public and private sector causes policymakers to consider moderate solutions which include objectives and positive characteristics of both sectors. One solution is contracting with private sector. Despite the increased use of this method,, there is no model that includes worldwide experiences, scientific studies or correspond to Iran health care system. This research follows to produce practical model for this issue. Methods: This practical research is descriptive- analytic and cross-sectional in which the data is gathered from selected countries -Newzeland, United Kingdom, Estonia, Australia, India and Iran - to provide a primary (suggestive) model. That was evaluated by thirty specialists and then the ultimate model was presented. Findings: According to the findings different kinds of contracting can be used in purchasing logistic and paraclinic services in hospitals, screening and control of specific diseases, patient transportation and primary health care. Also, the use of performance-based contract for allocation of resources among different levels of health system, insurance companies and hospitals was emphasized but outsourcing of clinical services and build-own-operate contracts was not approved. Conclusion: Results show that contracting can be used for purchasing of services in different level of health system. Government should move away from passive purchasing arrangement- i.e. those involving simple retrospective payment of providers - towards strategic forms of purchasing. The latter involve active decision about the services to be purchased and the objectives to be pursued.