A comprehensive review on strategic purchasing of diagnostic imaging services.

Diagnostic imaging services are one of the rapidly growing services in the healthcare industry and policymakers consider containing the cost of such services as a way to reduce the total cost of healthcare services. This study aimed to identify the components influencing the implementation of strategic purchase of diagnostic imaging services. This comprehensive review was done by searching databases including: Embase, Science Direct, PubMed, Web of Science, Scopus, ProQuest, and Persian databases SID, IranDOC, Magiran. Peer review articles in both Persian and English languages were included and those studies with lack of access to the full text and letter to the editor, summary of the book, and expression of views and opinions were excluded. Based on PRISMA statement, 15 original studies and 7 review studies were selected for data collection. The strategic purchasing framework introduced by the World Health Organization was used to analyze data. The dominant design in the original studies was a qualitative approach through interviews with experts, and one study has been conducted specifically in the field of medical equipment. Fifty-six components were identified. The identified components intended to address the five major questions about strategic purchasing; also we added the sixth dimension to the framework, which is strategic purchasing stewardship. Items that were placed in six dimensions were 11, 10, 8, 11, 7, and 10 in stewardship, what to buy, for whom to buy, from whom to buy, at what price to buy, and what mechanism to buy, respectively. In the context of strategic purchasing of diagnostic imaging services, special attention should be paid to the competitive advantages of suppliers, organization structure and history of providers, performance evaluation, and accreditation of providers. It is suggested that the regionalization program of services in different regions and the accreditation of institutions and organizations providing diagnostic imaging services should be considered as the prerequisites of this approach.