Journal
HEALTH POLICY
Volume 122, Issue 5, Pages 457-472Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.healthpol.2018.01.014
Keywords
Strategic purchasing; Contracting; Purchasing; International health systems; European health systems; Health systems in transition
Funding
- Weiser Center for Europe and Eurasia (WCEE) at the University of Michigan
- Office of Global Public Health at the University of Michigan School of Public Health
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Strategic purchasing of health care services is widely recommended as a policy instrument. We conducted a review of literature of material drawn from the European Observatory on Health Systems and Policies Health Systems in Transition series, other European Observatory databases, and selected country-specific literature to augment the comparative analysis by providing the most recent healthcare trends in ten selected countries. There is little evidence of purchasing being strategic according to any of the established definitions. There is little or no literature suggesting that existing purchasing mechanisms in Europe deliver improved population health, citizen empowerment, stronger governance and stewardship, or develop purchaser organization and capacity. Strategic purchasing has not generally been implemented. Policymakers considering adopting strategic purchasing policies should be aware of this systemic implementation problem. Policymakers in systems with strategic purchasing built into policy should not assume that a purchasing system is strategic or that it is delivering any expected objectives. However, there are individual components of strategic purchasing that are worth pursuing and can provide benefits to health systems. (C) 2018 Published by Elsevier B.V.
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