Research Of PPP Application In China's Hospital Projects

The medical service is characterized with quasi-public product attributes,which will benefits other people and society.Due to the asymmetry of information between doctors and patients,in order to maximize the economic and social utility,government shall not allow medical resources allocation totally controlled by market,otherwise,the optimal allocation of medical resources will not be implemented,the medical service will not be improved,the health of people will not be ensured.Guiding and attracting social capital to access medical services industry under the supervision of the government is an effective way to improve medical service efficiency.There are many successful experiences of hospital projects provided by using PPP model in both developed and developing countries.Introducing PPP model to medical and health service system in our country will ease the pressure on government spending,transfer the risk of public sector,improve the efficiency medical service supplement,rich investment channels of social capital,guarantee the health of masses and strengthen social stabilization.Firstly,this thesis will analyze the necessity of PPP hospital project from the current situation and planning outline of medical and health services in China,demonstrates the feasibility of PPP hospital project from the mature policy environment and the constantly importation in hospital construction operation management.Putting forward four possible patterns by combining the property owner and management category,then analyze the feasibility and features of these four patterns by comparison with the definition of PPP model,then make a suggestion that holding a nonprofit hospital by PPP model will meet current policy requirements.Putting forward three feasible PPP models of nonprofit hospital project by combining the property owner(government or government and social capital),type of project(construction projects or medical service operation projects,construction projects including new project,renovation project,and relocation project),product type of project output(public product,quasi-public product,or private products),which are BOT,TOT/ROT and BOO models.For new hospital projects,if the social capital is responsible for the financing,construction,operation and maintenance of infrastructure and non-medical service,BOT operation mode could be adopted,the investment return mechanism is viability gap funding;for renovation hospital project,if the social capital is responsible for the financing,construction,operation and maintenance of infrastructure and non-medical service,TOT/ROT operation mode could be adopted,the investment return mechanism is viability gap funding;for relocation hospital project,if the social capital is responsible for the financing,construction,operation and maintenance of infrastructure,non-medical service,medical service and profit-making business,BOO operation mode could be adopted,the investment return mechanism are government payment and user charge.Secondly,this thesis will analyze the transaction structure,investment and financing structure,investment return mechanism,risk allocation principle,operating procedures,contract system,subject definition and critical success factors of these three operation modes.At last,this thesis takes Central Hospital Phase II project PPP project of city A,the new Maternal and Child Health Hospital PPP project of city B,Chinese medicine Medical Center PPP project of county C as examples,explaining the transaction structure,operation process,main contract points and effect of critical success factors under BOT,TOT/ROT,BOO typical development model.