Strategic purchasing and health systems resilience: Lessons from COVID-19 in selected European countries

Marie C Montás¹, Katarzyna Klasa², Ewout van Ginneken³, Scott L Greer⁴

Affiliations

¹ Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address: mchantel@umich.edu.
² Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
³ European Observatory on Health Systems and Policies, Technische Universität Berlin EB2 EB 2, Strasse des 17.Juni 145, Berlin 10623, Germany; Department of Health Care Management, Berlin University of Technology, Technische Universität Berlin, Strasse des 17. Juni 145, Berlin 10623, Germany.
⁴ Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States; European Observatory on Health Systems and Policies, Technische Universität Berlin EB2 EB 2, Strasse des 17.Juni 145, Berlin 10623, Germany.

PMID: 35773063
PMCID: PMC9195347
DOI: 10.1016/j.healthpol.2022.06.005

Review

Strategic purchasing and health systems resilience: Lessons from COVID-19 in selected European countries

Marie C Montás et al. Health Policy. 2022 Sep.

. 2022 Sep;126(9):853-864.

doi: 10.1016/j.healthpol.2022.06.005. Epub 2022 Jun 14.

Authors

Marie C Montás¹, Katarzyna Klasa², Ewout van Ginneken³, Scott L Greer⁴

Affiliations

¹ Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States. Electronic address: mchantel@umich.edu.
² Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
³ European Observatory on Health Systems and Policies, Technische Universität Berlin EB2 EB 2, Strasse des 17.Juni 145, Berlin 10623, Germany; Department of Health Care Management, Berlin University of Technology, Technische Universität Berlin, Strasse des 17. Juni 145, Berlin 10623, Germany.
⁴ Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States; European Observatory on Health Systems and Policies, Technische Universität Berlin EB2 EB 2, Strasse des 17.Juni 145, Berlin 10623, Germany.

PMID: 35773063
PMCID: PMC9195347
DOI: 10.1016/j.healthpol.2022.06.005

Abstract

Strategic purchasing is a popular and frequently proposed policy for improving the efficiency and adaptiveness of health systems. The COVID-19 pandemic shocked health systems, creating a test of the adaptability and resiliency of their key features. This research study explores (i) what role purchasing systems and agents played in the COVID-19 pandemic, (ii) if it was strategic, and (iii) how it has contributed to a resilient health system. We conducted a qualitative, comparative study of six countries in the European Union-focusing on three as in-depth case studies-to understand how and when strategic purchasers responded to seven clearly defined health system "shocks" that they all experienced during the pandemic. We found that every case country relied on the federal government to fund and respond to the pandemic. Purchasers often had very limited, and if any then only passive, roles.

Keywords: COVID-19 pandemic; Contracting; European health systems; Health systems resilience; Payers; Purchasing.

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Conflict of interest statement

All authors declare that they have no conflicts of interest.

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Strategic purchasing and health systems resilience: Lessons from COVID-19 in selected European countries

Affiliations

Strategic purchasing and health systems resilience: Lessons from COVID-19 in selected European countries

Authors

Affiliations

Abstract

Conflict of interest statement

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