Factors Associated with Outsourcing Support Services by General Hospitals in Uganda

The objective of this study was to identify factors associated with the decision, process and practices of outsourcing support services by general hospitals in Uganda.

A cross sectional survey design was used; 32 hospitals were sampled using stratified random sampling. Trained research assistants distributed self-administered questionnaires to managers in the sampled hospitals. Wilcoxon-Mann-Whitney tests were performed on the collected data using SAS 9.3.

Majority (59%) of hospitals surveyed were rural; 41% were urban. More than half (n=23; 72%) reported to be outsourcing at least one support service. There was a significant difference in the proportion of rural and urban hospitals outsourcing and those not outsourcing (p=0.0033). While outsourcing, rural hospitals were more likely to report challenges with the availability of vendors (p= 0.0152); urban hospitals were more likely to report challenges with contractual issues (p=0.0056). Ministry of Health owned hospitals were more likely to report political interference in the outsourcing process (p= 0.0065). Rural hospitals were more likely to monitor the continued need for outsourcing compared to their urban counterparts (p=0.0358). We found no significant differences (p>0.05) in the hospital managers’ perceptions about the benefits of outsourcing, outsourcing risks, characteristics of services that need to be outsourced and outsourcing barriers among outsourcing and non-outsourcing hospitals.

Hospital location and ownership have an influence on aspects of the outsourcing decision, process and practices by general hospitals in our study. However, the perceptions of the hospital managers regarding outsourcing have no influence on the hospital’s outsourcing decision and practices.