The impact of outsourcing operating theatre support services on hospital performances: the case of the largest university hospital of the Albania

Hospitals in most of the countries in transition face the challenge to raise efficiency in a rapidly evolving health sector. In this framework, the Albanian Ministry of Health has outsourced the sterilization and operating theatre support(SOTS) services of all the public hospitals. The aim of this article is to evaluate the impact of the outsourcing of SOTS services on the productivity of the surgical services. A case study analysis was conducted in the Country's largest hospital. Surgical activity data of all the surgical services were analyzed. Furthermore, interviews with key stakeholders were conducted in order to enable a more detailed exploration of the results. Compared with the previous twelve months, a relevant increase in the total number of surgical interventions performed by the hospital was registered in the twelve months after the introduction of the new organizational model (+14%); this significant increase occurred in almost all the surgical services. Results of the interviews highlighted several organizational-, supply capacity-, and confidence-related determinants behind the productivity gains. These findings have significant implications for poorly performant-but increasingly competitive and evolving-hospital sectors of countries in transition, in which the outsourcing of SOTS services may represent a key tool for enhancing the productivity.