SAĞLIK HİZMETLERİNİN ÖRGÜTLENMESİNDE KAMU-ÖZEL ORTAKLIĞI

Abstract

Keywords

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SAĞLIK HİZMETLERİNİN ÖRGÜTLENMESİNDE KAMU-ÖZEL ORTAKLIĞI

Abstract

Kamu-özel ortaklığı, yönetim ilişkisini kuşatan ve dönüştüren sözleşme temelinde bir örgütlenme modelidir. Sağlık alanında hızla yaygınlaşan bu model, hizmetlerin işletmecilik esasları temelinde örgütlendirilmesine dayanmakta olup, hizmetlerin finansmanı ve örgütlenme ilke ve değerleri açısından piyasa dostu bir modeldir. Devletin sadece tıbbi hizmet (çekirdek hizmet) üretiminde yer aldığı bu modelde, sağlık tesislerinin yapımı, tıbbi destek ve tıbbi olmayan hizmetlerin sunumu ve ticari alanların işletilmesi özel sektöre (tek bir ortak girişime) blok halinde devredilmektedir. Bu şekilde ölçeğin de büyütüldüğü modelin kilit özelliği, finansman biçimidir. Devlet, uzun süreli sözleşmelerle ortak girişimden temin ettiği mal, hizmet ve yapım işinin karşılığını bütçe dışı yollarla, yıllık kira şeklinde ödemektedir. Yazı, sağlık hizmetleri alanında Türkiye’de kamu-özel ortaklığı modeliyle yapılacak hastanelerin örgütlenme biçimini, modeli uygulayan farklı ülkelerin deneyimlerinden de yararlanarak analiz etmeyi amaçlamaktadır. Çalışmada model, dayandığı neo liberal örgüt kuramlarının varsayımları açısından da test edilerek eleştirel bakışla değerlendirilmektedir.

Keywords

• Kamu-özel ortaklığı, kamu örgütlenmesi, sözleşme ilişkisi, sözleşme yönetimi, sağlık yönetimi

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