The study objectives were as follows:
- To analyze foreign experience in implementation of social and economic efficiency evaluation mechanisms as a tool of decision making in health care system,
- To elaborate used in international practice approaches to select projects in health care systems which could be implemented with such an important institutional mechanism of engaging private investment in the sector as private-public partnership (PPP),
- To consider theoretical basis and used in international practice tools for evaluation of social and economic efficiency of PPP projects in health care systems,
- To substantiate necessity to evaluate economic feasibility of proposed investment projects realized both under current practice and using new institutional form such as different models of PPP,
- To analyze main directions of PPP development in health care systems of foreign countries.
Methodology: Search of legal and normative documents adopted in different countries and aimed to regulate institutional systems of: (a) evaluation of social and economic efficiency of medical technologies, programs and interventions, (b) private sector engaging in health system development, (c) to evaluate health PPP projects efficiency. Search of scientific publications devoted to health technology (program, intervention) assessment introduction impact evaluation as well as to the issues of efficiency evaluation of the health projects carried out under PPP.
Empirical base of the study: Search was made in the following databases: NHS-Pharmline, NHS EED, OHE HEED, German economic evaluations. Sites of the Ministries of health of different countries were included into the search. Search of research publications were made in the following databases Embase, Pubmed (Medline), NHS-Pharmline, NHS EED, OHE HEED, German economic evaluations and at the sites of international organizations (such as World Health Organization, the World Bank, European Union, etc.). As a result of the search more than 120 documents and publications, aimed to regulations of issues of efficiency assessment of medical technology and health PPP projects, were selected and analyzed, including more than 50 legal documents adopted in USA, Canada and some European countries (such as United Kingdom, Germany, others) and more than 70 scientific articles published overseas.
Study results:Carried out analysis of international experience of implementation of new institutional form of health project realization – PPP – permitted: (a) to determine methodological approaches used in different countries to evaluate efficiency of health PPP projects, (b) to define criteria of project selection carried out with PPP, (c) to define main characteristics of health PPP projects in foreign countries, their potential advantages compared with traditional purchasing forms and risks of health PPP projects, (d) based on analysis of international experience to develop proposals which could be useful under the Russian conditions and which could promote further expansion of health PPP projects in Russia.
Level of implementation, recommendations on implementation or outcomes of the implementation of the results: Study results could to used to develop mechanism to realize Strategy of health care system development, draft of which was recently published by the Ministry of Health of the Russian Federation. Presented in the report analysis and information could be of value for the Ministry of Economic Development of the Russian Federation when it develops methodological and regulative documents to select projects which could and should be realized as PPP projects, as well as to carry out evaluation of their efficiency. Presented in the report information and data could be useful to complete draft law on PPP. Findings of the report could be of interest for the regional authorities which develop their PPP programs.