University of Michigan, School of Public Health, Department of Health Management and Policy, 1415 Washington Heights, Ann Arbor, MI, 48109, United States of America.
European Observatory on Health Systems and Policies, Technische Universität Berlin EB2 EB 2, Department of Health Care Management, Strasse des 17. Juni 145, 10623, Berlin, Germany; Berlin University of Technology, Technische Universität Berlin, Department of Health Care Management, Strasse des 17. Juni 145, 10623, Berlin, Germany.
Health Policy. 2018 May;122(5):457-472. doi: 10.1016/j.healthpol.2018.01.014. Epub 2018 Feb 5.
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.
医疗服务的战略性采购被广泛推荐为一种政策工具。我们对来自欧洲卫生系统和政策观察站的卫生系统转型系列、其他欧洲观察站数据库以及选定的特定国家文献的资料进行了文献回顾，以提供十个选定国家的最新医疗保健趋势来补充比较分析。根据任何既定的定义，很少有证据表明采购具有战略性。几乎没有或根本没有文献表明欧洲现有的采购机制能够改善人口健康、增强公民权能、加强治理和管理，或发展采购方的组织和能力。战略性采购尚未普遍实施。考虑采用战略性采购政策的政策制定者应该意识到这一系统性实施问题。在将战略性采购纳入政策的系统中，政策制定者不应假设采购系统具有战略性，或者它正在实现任何预期目标。然而，战略性采购的个别组成部分值得追求，并可以为卫生系统带来益处。
