A direct comparison of the performance of public-private partnerships with that of traditional contracting / Una comparación directa del desempeño de una CPP con el modelo tradicional de contratación pública / Uma comparação direta do desempenho de uma PPP com o modelo tradicional de contratação pública

Abstract This paper assesses the city of Belo Horizonte's experience building school infrastructure through public-private partnerships (PPPs). Between 2009 and 2015, Belo Horizonte built very similar schools using both PPPs and traditional public contracting (TPC). As the choice of mode of contracting was unrelated to our outcomes of interest, the experience constitutes a quasi-experiment that allows for a simple and direct comparison of PPPs to TPC. We examine construction- and operation-phase outcomes measured using administrative data and a survey of school administrators. We find that schools constructed under the PPP contracting model outperformed those built using TPCs in most outcomes.

Resumen Este artículo evalúa la experiencia del municipio de Belo Horizonte en la construcción y operación de infraestructura escolar a través de una Colaboración Público-Privada (CPP). Entre 2009 y 2015, Belo Horizonte construyó escuelas similares usando tanto CPPs como el modelo tradicional de contratación pública (MTCP). Dado que la elección del modelo de contratación no tenía relación causal con los resultados evaluados, se puede afirmar que esa experiencia constituye un cuasi experimento que permite la comparación simple y directa de las CPPs con el MTCP. Evaluamos los principales resultados en las etapas de construcción y operación usando datos administrativos sumistrados por la alcaldía y con cuestionario aplicado a los directores de las escuelas. El artículo muestra que las escuelas construidas en el modelo de CPP tuvieron un desempeño mejor que las que usaron el MTCP.

Resumo Este artigo avalia a experiência do município de Belo Horizonte na construção e operação de infraestrutura escolar por meio de Parcerias Público-Privadas (PPPs). Entre 2009 e 2015, Belo Horizonte construiu escolas similares usando tanto PPPs como o modelo tradicional de contratação pública (MTCP). Dado que a escolha do modelo de contratação não tinha relação causal direta com os resultados avaliados, pode-se afirmar que essa experiência constitui um quasi experimento que permite a comparação simples e direta das PPPs com o MTCP. Avaliamos os principais resultados nas fases de construção e operação usando dados administrativos fornecidos pela prefeitura e com questionário aplicado aos diretores das escolas. O artigo mostra que as escolas construídas no modelo de PPP tiveram um desempenho melhor do que as que usaram o MTCP.

Efectos de la musicoterapia en el nivel de intensidad del dolor postquirúrgico en pacientes pediátricos en un hospital de EsSALUD / Effects of music therapy in intensity level post surgical pain in pediatric patients in EsSALUD hospital

Objetivos: determinar los efectos de la musicoterapia, como tratamiento complementario, en el nivel de intensidad del dolor postquirúrgico en pacientes pediátricos en el servicio de Neurocirugía del Hospital Nacional Guillermo Almenara Irigoyen. Material y Métodos: estudio cuasi experimental. Muestra: 40 pacientes pediátricos de 5 a 17 años, 20 pacientes del grupo experimental que recibieron sesión de musicoterapia clásica por 30 minutos y 20 pacientes grupo control quienes no recibieron sesión de musicoterapia, en ambos grupos se utilizaron escalas CHEOPS (de 5 a 7años), facial (8 a 17 años). Resultados: el puntaje del dolor en el grupo experimental de 8 a 17 años a las 24 horas post operados fue de 5 ± 1,9 (moderado) y posterior a la musicoterapia, el puntaje del dolor fue de 3,2 ±1,6 (moderado), encontrándose una reducción del dolor en 1,8 puntos, estadísticamente...

Objectives: delimit the effects of music therapy, as complementary treatment, on the level of intensity of postoperative pain in pediatric patients in the Neurosurgery Department of the Hospital Guillermo Almenara Irigoyen. Material and Methods: design quasi-experimental, sample: 40 pediatric patients of 5-17 years old, 20 patients of experimental group received classical music therapy session for 30 minutes and 20 patients of control group not received music therapy session, both groups used CHEOPS scales (5-7 years), facial (8-17 years). Results: the pain score in the experimental group of 8-17 years after 24 hours of post-surgery was 5 ñ 1.9 (moderate) and after music therapy, the pain score was 3.2 ñ 1,6 (moderate). It was found a reduction in pain of 1,8 points statistically...

The effect evaluation of continuous care pathway on hypertension control:Evidence from a ru-ral community-based quasi-experiment / 中国卫生政策研究

Objectives:To test the effect of continuous care on rural hypertension control , we developed a com-prehensive intervention strategy and implemented a community-based quasi-experiment in Southwestern rural China.Methods:The intervention took place in Qianjiang District , Chongqing Municipality from July 2012 to June 2014.4 towns were randomly selected and categorized into 2 groups based on a comprehensive consideration of population and social development level.All the rural hypertension patients in treatment group were intervened with the Multi-institu-tional Continuous Pathway which was consisted of three parts:the Continuous Primary-Care Pathway , the Continuous Clinical Pathway and the Continuous Management Pathway.The patients in the control group served as a blank com-parison using the usual care.Difference-in-differences Model was used to test the effect of blood pressure control in treatment group.Results:853 patients were sampled and investigated using the stratified randomly sampling strategy and 712 of them had been followed up by the end of this program.The potential bias of pilot and patient selection were eliminated through control before and after the intervention.The previous blood pressure trends showed no statis-tically significant difference between groups.The systolic blood pressure in treatment group declined by 10.156 mm-Hg ( P<0.001 ) compared to control group after intervention , and the blood pressure control rate had increased by 27.6% ( P<0.001 ).Other contributing factors besides intervention were family structure , education level and med-ical service availability.Conclusion:The continuous care pathway have a significant marginal positive effect on hyper -tension control besides the national compulsory primary care , and the control rate change of blood pressure is more sen-sitive compared to blood pressure change.The potential contributing factors show that other intervention strategies could be developed to improve the rural hypertension control by adding to the social capital of rural patient , reinforcing the health education and facilitating the village transportation.

A quasi-experimental research on hospitalization process recombination for common disease entities in general surgery / 中华医院管理杂志

Objective To shorten the average length of stay for single disease entities and enhance the hospitals competitiveness through hospitalization process recombination while guaranteeing the quality of its medical service. Method The method of "systematic reintegration" from the theory of operation process recombination was adopted to recombine the hospitalization process for common disease entities in general surgery. Result After the recombination, the number of discharged patients with disease entities covered by the year 2000 research increased by 14.78%, the average length of stay was shortened by 3.83 days, a reduction of 21.58%, the average hospitalization fees incurred on the patients were reduced by 108 yuan, a reduction of 1.18%, and the business income increased by 13.43%, as compared with 1999, when recombination was not yet initiated. Conclusion Hospitalization process recombination can improve the quality and efficiency of a hospitals medical service and increase its business income while its medical service resources remain unchanged.