Theoretical foundations for developing a regional system of medical services based on public–private partnership (PPP) production

Abstract

The article provides a theoretical rationale for developing a regional system of medical services based
on public–private partnership (PPP). Drawing on an analysis of domestic and international literature, the regulatory
framework of the Republic of Uzbekistan, national statistics, and reports by analytical agencies, it identifies three
core methodological frameworks: institutional, contractual, and systems approaches. It shows that the institutional
environment determines the feasibility of PPP implementation; contract theory defines principles of risk allocation and
payment mechanisms; and the systems approach requires integrating projects into a unified regional care network.
The paper proposes ways to enhance effectiveness: ex-ante value-for-money (VfM) assessment, standard KPIs for
replicable models, and stronger contract management within health authorities. The materials and conclusions are
intended for the academic community and practitioners of regional health policy