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Does Strategic Purchasing Improve Health Systems? A Literature Review - P4H Network

Does Strategic Purchasing Improve Health Systems? A Literature Review

Strategic purchasing aims to improve healthcare spending and access, but how well it works depends on design and local factors. This review in the Health Systems Reform Journal explores the evidence for its effectiveness.

This review examines evidence on strategic purchasing, an approach touted for improving healthcare spending efficiency, access, quality, and progress toward universal coverage. Despite its promise, the evidence on its effectiveness is limited. Researchers explored how purchasing functions (e.g., contracting, payment methods) influence resource allocation, incentives, accountability, and ultimately, health system outcomes. The study suggests these outcomes depend on how purchasing is designed, implemented, and the context (funding, political climate, health system development). Strong public funding and pooling of resources are seen as crucial for maximizing the value of strategic purchasing. This review offers valuable insights for policymakers seeking to optimize this approach for health system improvement.