Identifying Characteristics of PPP Projects for Healthcare Facilities for the Elderly Based on Payment Mechanisms in China

The rapidly increasing aging population requires a corresponding increment of healthcare facilities for the elderly to achieve a sustainable community. As public–private partnership (PPP) is a proven method for supporting the financial viability of various types of infrastructure projects, governments have recently adopted PPP for eldercare facility projects. However, there are limited methods to support decisions on payment mechanisms, which is one of the fundamental factors required to make PPP contracts. This study investigated the relationships between the characteristics of eldercare facility projects and payment mechanisms [e.g., viability gap funding (VGF)]. This study applied a multivalue qualitative comparative analysis (mvQCA) with 26 case studies, which could be considered the best practice in China. Based on the analysis, the authors identified five and three configurations of project attributes for VGF (i.e., VGF user-fee) and user charge (i.e., non-VGF user-fee) mechanisms, respectively. This finding supports informed decision-making on payment mechanisms of PPP projects for healthcare facilities for the elderly. Further research in other countries is necessary to identify not only general but also culturally and politically specific configurations of attributes for different payment mechanisms.