Public-Private Partnerships in the Healthcare Sector and Sustainability: Managerial Insights from a Systematic Literature Review

• Published date: 01 November 2024
• DOI: http://doi.org/10.1177/00953997241275576
• Author: Fabio De Matteis,Fabrizio Striani,Giovanni Notaristefano,Rocco Caferra
• Date: 01 November 2024

https://doi.org/10.1177/00953997241275576

Administration & Society

2024, Vol. 56(9-10) 1146 –1174

© The Author(s) 2024

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DOI: 10.1177/00953997241275576

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Article

Public-Private

Partnerships in the

Healthcare Sector

and Sustainability:

Managerial Insights

from a Systematic

Literature Review

Fabio De Matteis1, Fabrizio Striani2,

Giovanni Notaristefano1, and Rocco Caferra3

Abstract

This article aims to critically understand the current state of the art of

Public-Private Partnerships (PPPs) in the health sector and to highlight

implications useful for implementing sustainability-oriented PPPs. By

employing text mining to analyze the sampled articles, we identify the main

themes distinguishing healthcare PPPs and sustainability. We critically discuss

the narrative underlying the results achieved in terms of emerging topics:

governance, managerial tools, barriers, advantages/disadvantages, and big

data. Finally, we propose a literature-driven framework on PPP management

that identifies implications – systemic approach, technical managerial

skills, governance balance, operational instruments – that can facilitate the

development of sustainability-oriented PPPs in the healthcare sector.

1University of Bari, Taranto, Italy

2University of Salento, Lecce, Puglia, Italy

3Unitelma Sapienza University of Rome, Italy

Corresponding Author:

Fabrizio Striani, Department of Innovation Engineering, University of Salento, Lecce, Via per

Monteroni s.n., 73100, Italy.

Email: fabrizio.striani@unisalento.it

1275576AAS0010.1177/00953997241275576Administration & SocietyDe Matteis et al.

research-article2024

De Matteis et al. 1147

Keywords

public-private partnership, healthcare, sustainability management

Introduction

Health protection and sustainability are two closely related aspects that

healthcare organizations should not manage separately (Borgonovi et al.,

2018; Mehra & Sharma, 2021). This area is of particular relevance to society,

reflecting the growing interest of citizens who are also patients and taxpayers

in the public health system.

Considering the complexity of governance in healthcare organiza-

tions, we seek to critically understand the relevant topics of a particular

governance configuration, namely Public-Private Partnerships (PPPs),

to highlight some managerial implications that may be useful for imple-

menting sustainability-oriented PPPs. To achieve this, we employ a lit-

erature revie w methodology to identify the main aspects of this promising

relationship.

Numerous configurations of health systems are possible. In fact, from the

combination of the three pivotal dimensions that characterize health systems

(financing, health service delivery, and regulation), it is possible to obtain

several distinct types of health systems that fall between two main extremes:

a state health system and a private health system (Wendt et al., 2009). As a

result, we can consider three modes of healthcare delivery: (a) mainly private

providers (US), (b) public and private providers (Bismarck Model countries:

e.g., Germany, France), (c) mainly public providers with a reduced private

sector (Beveridge Model countries: e.g., Italy, U.K., Sweden, Canada).

Due to the COVID-19 pandemic, both public and private healthcare sec-

tors are growing in the healthcare market. Examining the relative benefits of

the public versus private healthcare sectors, proponents of private healthcare

systems argue for advantages such as profit and efficiency maximization; they

believe that the competitive market model can improve efficiency, quality,

consumer choice, responsiveness, transparency, and accountability (Kaabi

et al., 2022). Evidence suggests different results, however. Hollingsworth

(2008) showed that “public provision is potentially more efficient than pri-

vate provision.” According to Lee et al. (2009), non-profit hospitals are more

efficient than for-profit hospitals in the United States.

Indeed, the countries with the best healthcare provide free or universal

healthcare. Countries such as Sweden, New Zealand, Spain, Portugal, Japan,

Italy, Ireland, Germany, France, Australia, Canada, and South Korea provide

healthcare following the principles of non-profit public administration