Journal of

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Background: In recent years, Hashemi Nejad Hospital was outsourced or insourced some of their services to private sector or will have decision to do it. Selection and assessment of suppliers in outsourcing of hospital services is a critical issue. In this study, selecting and evaluating suppliers for outsourcing services in hospitals was evaluated.
Materials and Methods: In order to achieve the goal, evaluating and selecting outsourcing service providers with studies and using opinion of the experts and medical experts, consisting of hospital manager, quality manager, HR managers, officials outsourced parts and other experts in this respect which includes 14 criteria. Identified criteria were clustered in three areas of service features, characteristics and criteria for communications suppliers in the supply chain; supplier selection problem is the problem multi-criteria decision. So, criteria were ranked and weighted using the Expert choice 11 software and AHP.
Results: Based on the study results, sub-criteria of the quality of service, management systems, customer care, and information security had greatest impact on the selection of suppliers and sub-criteria, geographic location, flexibility and problem solving had the lowest priority.
Conclusion: C supplier had the highest priority according to the communication criteria and A supplier had the highest priority according to two other criteria. In total, the supplier A had the first priority, supplier B had the second priority and supplier C had the third priority.

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Background: This study aimed to explore the process of establishing a non-governmental and nonprofit  hospital, as a corporate infantry, and a model for the establishment of autonomous and corporate hospitals.
Materials and Methods: This was a qualitative case study. The data were collected by interviewing the founders of Moheb Mehr Hospital, staff and some university officials and charity organizations. The data analysis was conducted based on grounded theory principles and data were coded in three stages of open, axial and selective coding.
Results: The primary factors behind the establishment of Moheb Hospital were the low level of physicians' fees and the physicians’ dual practice in the public and private sectors. The existence of unused spaces at Hashemi-Nejad Hospital and the possibility of contracting supplementary insurance were the secondary factors. The reaction included welcoming from hospital physicians and opposition from the government and the Ministry of Health. A good patient access was created due to the lower charges, in comparison to the private sector, and having contract with the supplementary insurance. The negative comments from the government and the Ministry were gradually adjusted.
Conclusion: The decentralization initiatives of the public sector in hospitals should be considered as a bottom-up process. Instead of turning government hospitals into independent or corporate, it is better to re-establish them in an autonomous or corporate form. Also, before any decentralization action, financial and managerial stability must be created in the organizations. Morevoer, employee benefits must be preserved. Instead of receiving government funding, it is better to use the capacity of the endowment and receive bank loans.
 

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Background: Public-private partnership (PPP) in constructing and operating hospitals is a good strategy to provide high quality services to people at lower cost for the government.  However, PPP is facing several challenges. The objective of this research was to identify and explore the PPP challenges in building Moheb Yas hospital in Tehran, Iran.
Materials and Methods: A qualitative approach was used for this case study in 2018. In-depth semi-structured interviews were conducted with 24 key stakeholders, managers and employees who were involved in PPP initiative implementation using purposive and snowball sampling methods. Thematic analysis approach was used for data analysis.  
Results: Moheb Yas hospital was built in the yard of a public hospital (Co-location PPP) by the private entity. Then, the public hospital was moved into the private hospital. The new hospital was transferred to the government after one year owing to some challenges. These challenges include an inappropriate PPP model, low government capacity and competency in PPP, low trust in private partner, difficulty in funding the project, demolishing the old building, applying for hospital licences, merging two public and private hospitals, and difficulties in equipping the new hospital with human and physical resources.
Conclusion: The PPP was not successful in this case. Although PPP initiatives have benefits for the health system, but, it comes with numerous challenges especially in developing countries owing to disparate goals, incentives, and management practices of public and private sectors. The research findings provide useful insights for policy makers and senior managers in health systems in similar countries about the main barriers of PPP initiatives in the health sectors.