The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66477

John F P Bridges, Ph D and Phil Fijalkovich. Health Services Research, Case Western Reserve University, 10900 Euclid Av., Cleveland, OH 44106-4945, 216-368-6962, jfb12@cwru.edu

Decisions to modify the publicly provided hospital infrastructure in Australia are sensitive, but necessary, issues for governments to address. Despite the best efforts by health researchers and policy advisors to provide a solid evidence base – including studies of community need and the effectiveness, efficiency and outcomes for various hospitals services – many infrastructure decisions are poorly made. This is because some decisions are rushed to meet election deadlines, postponed to avoid a community backlash, or made sub-optimally to meet other objectives and/or concerns of the government of the day. Unlike many other decisions, poorly made capital infrastructure decisions can affect the provision of health services for many years. In addition to establishing an evidence base on what health care systems are socially optimal, health services researchers and policy advisors need to give politicians a strategy to facilitate necessary change. This study presents a number of important case studies that demonstrate how, and how not, to make infrastructure decisions. Stemming from a large national study of hospital infrastructure in Australia, these case studies include examples of various forms of private finance initiatives, public private partnerships, hospital closures, hospital mergers, and provision of health care services in small rural communities. While the paper focuses on the Australian context, an optimal change management strategy is discussed that could be used in other counties with publicly provided health services.

Learning Objectives:

• Participants in this session will develop an appreciation for importance of community involvement and private/public partnerships in the development of public health infrastructure. This will be achieved through a number of relevant case studies performed in Australia. At the end of this session participants will understand how to foster such partnership and understand the importance of minimizing adverse political influences.

Keywords: Community Collaboration, Public/Private Partnerships

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.