Research Project: Precedents and Goals
Precedents
The new project focuses on an analysis of the advance of the private hospital sector, from a historical perspective, concentrating on the market interest in covering this type of demand. Chronologically, the research starts off in the 1920s with the initiatives of doctors who created clinics and hospitals and continues to the first decades of the twenty-first century, with growing interest from the banking sector and investment funds, and their strategies in view of the shortcomings and problems of the public hospital system. All of this is contextualised by an international comparison. This analysis is pertinent to an international academic debate that is highly relevant to the present moment, focusing primarily on the case of Spain, and conducted by a multidisciplinary team comprising people from the disciplines of economic history, the history of medicine and political history.
Our starting hypothesis focuses on the fact that, within this new present context of precariousness and public sector cuts and increased demand for hospital coverage at a time of pandemic, the private sector of health care provision, where hospital companies have an essential role, has initiated a process of advance, taking advantage of the shortcomings of public systems. This growth fluctuates between competition and collaboration in different historical stages, and has favoured the current situation of expansion of private insurance companies and the creation of large private hospital groups. In the case of Spain, due to its hospital-centric system, these groups have greater weight. The predominance of the market in certain periods of health and hospital coverage justifies the need for its study. Therefore, the development of the private hospital system and its strategies with regard to the public sector from a long-term perspective constitutes the central objective of our project.
Goals
In short, the new project has three FUNDAMENTAL GOALS:
1. To analyse the development strategies of private hospital provision in Spain in relation to public hospital activity, taking into account the transformations of the capitalist system, from three perspectives:
- The legal form of hospitals in the private and public sectors (stock companies and the creation of large hospital groups, foundations, professional associations, etc.
- The area of functional specialisation of these hospitals depending on private and public demand (children’s and maternity clinics, surgical hospitals, psychiatric institutions, etc.)
- Identifying different regional models in the development of private hospital provision compared to the public sector, explaining the historical determinants in each case.
2. To include the Spanish case in the international debate and establish similarities and differences with respect to other countries regarding their behaviour from these three perspectives.
3. Finally, all these elements require a cross-cutting goal which enables us to assess the gender implications that the transformations of the capitalist system have generated in public and private hospital provision in Spain from an international perspective. In this section, there is special interest in analysing how this public and private provision has paid attention to the needs of women through children’s hospitals and maternity clinics.
KeyWords
| Health care financing Hospital services research Health Infraestructures | Health systems Public and Private Hospitals |
| History | Policy analysis |
| Spain | |
| European Union World | North America |
