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Performance comparison of public–private partnerships and traditionally procured hospitals

Author

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  • David Alarcón-Ramirez
  • José Oliveros-Romero
  • Daniel Mahn

Abstract

This study aims to understand the extent to which public–private partnership (PPP) and traditional procured (TP) models impact the performance of hospital infrastructure projects. We conduct a case study analysis that combines both qualitative and quantitative approaches, utilising primary and secondary data sources, including interviews, contracts, and operational records, to examine the perspectives of various stakeholders on the different ways hospitals manage their contracts. The results identify six main themes that define their performance differences: service quality and operations, the impact of bureaucracy on decision-making, dispute resolution, differences in construction times, the financing and payment models, and the process of making contract modifications and renegotiations. This study suggests that, in the context of hospital projects, the PPP model tends to outperform the TP model across multiple dimensions, as the evidence broadly supports the theory of PPPs and their anticipated benefits. The findings of this research may encourage debate and reflection on public–private collaboration in the health sector, thereby contributing to the development of policies and strategies that optimise the quality and efficiency of hospital services for the benefit of society. Case study analysis aims to compare public–private partnerships and the performance of traditionally procured hospitals.Themes identified from the comparison include service quality and operation, the impact of bureaucracy on decision-making, dispute resolution, differences in construction times, the financing and payment model, and the process of making contract modifications and renegotiations.This study suggests that, in the context of hospital projects, the PPP model tends to outperform the TP model across multiple dimensions.

Suggested Citation

  • David Alarcón-Ramirez & José Oliveros-Romero & Daniel Mahn, 2026. "Performance comparison of public–private partnerships and traditionally procured hospitals," Construction Management and Economics, Taylor & Francis Journals, vol. 44(2), pages 79-97, February.
  • Handle: RePEc:taf:conmgt:v:44:y:2026:i:2:p:79-97
    DOI: 10.1080/01446193.2025.2576548
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