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Review
. 2022 Sep;126(9):853-864.
doi: 10.1016/j.healthpol.2022.06.005. Epub 2022 Jun 14.

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

Marie C Montás  1 , Katarzyna Klasa  2 , Ewout van Ginneken  3 , Scott L Greer  4
Affiliations
Review

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

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

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.

References

    1. Mathauer I., Dale E., Meessen B., World Health Organization . World Health Organization; Geneva, Switzerland: 2017. Strategic purchasing for universal health coverage: key policy issues and questions; a summary from expert and practitioners’ discussions.
    1. Klasa K., Greer S.L., van Ginneken E. Strategic purchasing in practice: comparing ten European countries. Health Policy. 2018;122(5):457–472. - PubMed
    1. Greer S.L., Klasa K., van Ginneken E. Power and Purchasing: why strategic purchasing fails. Milbank Q. 2020;98(3):975–1020. - PMC - PubMed
    1. Thomas S., et al. European Observatory on Health Systems and Policies; Copenhagen: 2020. Strengthening health systems resilience: Key concepts and strategies. - PubMed
    1. Kruk M.E., Myers M., Varpilah S.T., Dahn B.T. What is a resilient health system? Lessons from Ebola. Lancet N Am Ed. 2015;385(9980):1910–1912. - PubMed