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RESEARCH HERD VolumE 3, NumbER 3, pp 70-86 CopyRIgHt ©2010 VENDomE gRoup, llC Private Investment in Hospitals: A Comparison of Three Healthcare Systems and Possible Implications for Real Estate Strategies Johan van der Zwart, MSc Arch; Theo van der Voordt, MSc Civil Engineering; and Hans de Jonge, MSc Arch basis of a literature review and document analysis, then Abstract schematized to show similarities and dissimilarities with regard to private investment in hospitals. Observations are based on a selection of recently published articles on private- Objectives: This article explores lessons to be learned from sector financing and its implications for healthcare real estate three different healthcare systems and the possible implica- decision making in the Netherlands, the United Kingdom, and tions for the management of healthcare real estate, in particu- Germany. lar in connection to the Dutch system. It discusses similarities Results: The strengths and weaknesses of three healthcare and differences among the different systems, in search of pos- systems with differing proportions of private and public sible consequences on cost, financing, and design innovation. investment in hospitals were explored. Research revealed a Background: To keep healthcare affordable in the future, the gap between intended effects and actual effects with regard Dutch government is currently in the process of changing to quality and cost. Costly private finance does not necessarily legislation to move from a centrally directed system to a so- lead to “value for money.” Transferring real estate decisions called regulated market system. The deregulation of real estate to private investors decreases the influence of the healthcare investment that accompanies the new healthcare delivery organization on future costs and quality. system offers healthcare organizations new opportunities, but Conclusions: The three healthcare systems show substantial also more responsibility and greater risk in return on invest- differences between public and private responsibilities. Less ment. Consequently, healthcare organizations must find new governmental involvement affords both opportunities and methods of financing. Private investment is one of the options. risks for hospitals. Private investment may lead to innovation, Methods: Three healthcare systems were analyzed on the improved efficiency, and cost reduction, provided that the costs and benefits of decisions are not separated between Author Affiliations: Mr. van der Zwart is a postgraduate PhD student in different stakeholders. A missing link between infrastructure real estate; Dr. van der Voordt is an associate professor in real estate; and Profes
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