Private hospitals in low- and middle-income countries: a typology using the cluster method, the case of Morocco.

BACKGROUND

The private healthcare sector has become an essential component of healthcare systems globally. This interest has increased with the universal health coverage agenda. However, in most low- and middle-income countries, few classificatory studies of the private hospital sector were carried out.

METHODS

This study describes the private hospital sector in a developing country setup and propose a typology that could facilitate the identification of its categories and the understanding of its organizational and strategic characteristics.

RESULTS

All private hospitals in Morocco as of December 31, 2021 including 397 facilities are included. Most hospitals are for-profit, poly-disciplinary, independent, commercial societies, have fewer than 30 beds or between 30 and 99 beds and are located in urban areas. Private hospitals have a median turnover of 9.8 million MAD and a median capital value of 2 million MAD. The clustering method identifies three main categories of private hospitals: for-profit hospitals with medium size and turnover, spread across the country but with a high concentration in large regions; not-for-profit hospitals, with medium to large size, high turnover, located in large regions and including university hospitals; and small for-profit hospitals with low turnover, independent ownership and wide distribution over the country. Three criteria have the most significant discriminatory power: ownership, size (beds, turnover) and mode of governance.

CONCLUSIONS

Private hospitals in Morocco are organized into three types according to three similarity criteria including ownership, size and governance. These criteria might be used as the basis for a common typology of private hospitals in Morocco and possibly in other low- and middle-income countries with similar contexts.