Italy, as many other countries, adopted the design–build–finance–maintain (DBFMO) Anglo-Saxon model to build new hospitals. This model proved to be rigid, nontransparent, nonvalue for money, and unaffordable. The aim of this article is to analyze the main drawbacks of the traditional DBFMO public–private partnerships (PPP) contract applied to the health care sector, by referring to the Italian experience, and to discuss the evolutions, conceived through an inductive/deductive approach, conducted in a context of deep collaboration between academia, health care authorities, and market players to make PPP contracts more value for money, flexible, and affordable. The article provides also an example of the role of academia in closing the rigor–practice gap by supporting and facilitating an institutional change.

中文翻译：

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医疗保健中的 PPP——趋向于轻型模式：来自意大利的证据

与许多其他国家一样，意大利采用了设计-建造-财务-维护 (DBFMO) 盎格鲁-撒克逊模式来建造新医院。这个模型被证明是僵化的、不透明的、不物有所值的，而且负担不起。本文的目的是通过参考意大利的经验，分析适用于医疗保健部门的传统 DBFMO 公私合作 (PPP) 合同的主要缺点，并讨论通过归纳/演绎方法构思的演变，在学术界、卫生保健当局和市场参与者之间深入合作的背景下进行，以使 PPP 合同更物有所值、灵活和负担得起。这篇文章还提供了一个例子，说明学术界通过支持和促进制度变革在缩小严格性与实践差距方面的作用。