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Outsourcing public sector activities - How is quality maintained when public health care services are subject to contracting out?

Högberg, Emelie LU (2010) NEKM01 20101
Department of Economics
Abstract (Swedish)
In recent years outsourcing of public health care activities has increased in Sweden.
Outsourcing of public health care activities involves possibilities of innovation and
improvement according to many, but there are difficulties with how to maintain and control
quality in the outsourced activities. The focus of this thesis is on how quality is ensured when
public activities are subject to contracting out. Contractual relationships do not function in the
same way as administrative channels and therefore, as a result of outsourcing, new procedures
has to be developed in order to ensure quality. Material connected to the procurement process
of health care in Region Skåne and an interview conducted with an official are analyzed in
... (More)
In recent years outsourcing of public health care activities has increased in Sweden.
Outsourcing of public health care activities involves possibilities of innovation and
improvement according to many, but there are difficulties with how to maintain and control
quality in the outsourced activities. The focus of this thesis is on how quality is ensured when
public activities are subject to contracting out. Contractual relationships do not function in the
same way as administrative channels and therefore, as a result of outsourcing, new procedures
has to be developed in order to ensure quality. Material connected to the procurement process
of health care in Region Skåne and an interview conducted with an official are analyzed in
order to examine how quality is ensured. By examining how contracts are specified,
monitoring performed and accountability enforced it is clarified how quality is ensured in
activities operated by private health care providers with public funding. The results show that
quality is regulated in the contracts but that many of the quality measures are intangible.
Follow-up of the activities is carried out by patient surveys, reports and meetings with the
private health care providers. Accountability is enforced but through different channels than
in the public sector. The many difficulties with monitoring and operationalizing health care
outcomes contribute to the relatively intangible measures and control of quality. Furthermore,
in order to allow for innovation some responsibility has to be left to the provider. (Less)
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author
Högberg, Emelie LU
supervisor
organization
course
NEKM01 20101
year
type
H1 - Master's Degree (One Year)
subject
keywords
public procurement, transaction cost, principal-agent, health care, Region Skåne
language
English
id
1613672
date added to LUP
2010-06-23 12:55:41
date last changed
2010-06-23 12:55:41
@misc{1613672,
  abstract     = {In recent years outsourcing of public health care activities has increased in Sweden.
Outsourcing of public health care activities involves possibilities of innovation and
improvement according to many, but there are difficulties with how to maintain and control
quality in the outsourced activities. The focus of this thesis is on how quality is ensured when
public activities are subject to contracting out. Contractual relationships do not function in the
same way as administrative channels and therefore, as a result of outsourcing, new procedures
has to be developed in order to ensure quality. Material connected to the procurement process
of health care in Region Skåne and an interview conducted with an official are analyzed in
order to examine how quality is ensured. By examining how contracts are specified,
monitoring performed and accountability enforced it is clarified how quality is ensured in
activities operated by private health care providers with public funding. The results show that
quality is regulated in the contracts but that many of the quality measures are intangible.
Follow-up of the activities is carried out by patient surveys, reports and meetings with the
private health care providers. Accountability is enforced but through different channels than
in the public sector. The many difficulties with monitoring and operationalizing health care
outcomes contribute to the relatively intangible measures and control of quality. Furthermore,
in order to allow for innovation some responsibility has to be left to the provider.},
  author       = {Högberg, Emelie},
  keyword      = {public procurement,transaction cost,principal-agent,health care,Region Skåne},
  language     = {eng},
  note         = {Student Paper},
  title        = {Outsourcing public sector activities - How is quality maintained when public health care services are subject to contracting out?},
  year         = {2010},
}