University of Tampere, School of Health Sciences, School of Health Sciences FI-33014 University of Tampere, Finland.
Health Policy. 2013 Aug;111(3):221-5. doi: 10.1016/j.healthpol.2013.05.012. Epub 2013 Jun 19.
The purchaser-provider split (PPS) is a service delivery model in which third-party payers are kept organizationally separate from service providers. The operations of the providers are managed by contracts. One of the main aims of PPS is to create competition between providers. Competition and other incentive structures built into the contractual relationship are believed to lead to improvements in service delivery, such as improved cost containment, greater efficiency, organizational flexibility, better quality and improved responsiveness of services to patient needs. PPS was launched in Finland in the early 1990s but was not widely implemented until the early 2000s. Compared to other countries with PPS the development and implementation of PPS in Finland has been unusual. Firstly, purchasing is implemented at the level of municipalities, which means that the size of the Finnish purchasers is extremely small. Elsewhere purchasing is mostly implemented at the regional or national levels. Secondly, PPS is also applied to primary health care and A&E services while in other countries the services mainly include specialized health care and residential care for the elderly. Thirdly, PPS in health and social services is not regulated by any specific legislation, regulative mechanisms or guidelines. Instead it is regulated within the same framework as public procurement in general.
购买方-提供方分离（PPS）是一种服务提供模式，其中第三方付款人与服务提供者在组织上是分开的。提供者的运营由合同管理。PPS 的主要目标之一是在提供者之间创造竞争。竞争和合同关系中建立的其他激励结构被认为会导致服务提供的改进，例如更好的成本控制、更高的效率、组织灵活性、更好的质量以及更好地满足患者需求的服务响应能力。PPS 于 20 世纪 90 年代初在芬兰推出，但直到 21 世纪初才得到广泛实施。与其他实行 PPS 的国家相比，芬兰在发展和实施 PPS 方面的情况较为特殊。首先，购买方在市级层面实施，这意味着芬兰购买方的规模非常小。其他地方的购买方大多在地区或国家层面实施。其次，PPS 也适用于初级保健和急症服务，而在其他国家，这些服务主要包括专门的医疗保健和老年人的居住护理。第三，卫生和社会服务中的 PPS 不受任何特定立法、监管机制或准则的监管。相反，它是在与一般公共采购相同的框架内进行监管的。
