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

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  • Montás, Marie C.
  • Klasa, Katarzyna
  • van Ginneken, Ewout
  • Greer, Scott L.

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.

Suggested Citation

  • Montás, Marie C. & Klasa, Katarzyna & van Ginneken, Ewout & Greer, Scott L., 2022. "Strategic purchasing and health systems resilience: Lessons from COVID-19 in selected European countries," Health Policy, Elsevier, vol. 126(9), pages 853-864.
    • Handle: RePEc:eee:hepoli:v:126:y:2022:i:9:p:853-864
    DOI: 10.1016/j.healthpol.2022.06.005
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    References listed on IDEAS

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    1. Elisabeth Paul & Garrett Wallace Brown & Valéry Ridde, 2020. "Misunderstandings and ambiguities in strategic purchasing in low‐ and middle‐income countries," ULB Institutional Repository 2013/309855, ULB -- Universite Libre de Bruxelles.
    2. Habicht, Triin & Habicht, Jarno & van Ginneken, Ewout, 2015. "Strategic purchasing reform in Estonia: Reducing inequalities in access while improving care concentration and quality," Health Policy, Elsevier, vol. 119(8), pages 1011-1016.
    3. Elisabeth Paul & Garrett W. Brown & Valéry Ridde, 2020. "Misunderstandings and ambiguities in strategic purchasing in low‐ and middle‐income countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(5), pages 1001-1008, September.
    4. Marina Giachino & Camille Beatrice G. Valera & Sabina Rodriguez Velásquez & Muriel Anna Dohrendorf-Wyss & Liudmila Rozanova & Antoine Flahault, 2020. "Understanding the Dynamics of the COVID-19 Pandemic: A Real-Time Analysis of Switzerland’s First Wave," IJERPH, MDPI, vol. 17(23), pages 1-17, November.
    5. Christopher Hood & Ruth Dixon & Derek Hawes, 2015. "A Government that Worked Better and Cost Less?: Evaluating Three Decades of Reform and Change in UK Central Government," Post-Print hal-01577644, HAL.
    6. Klasa, Katarzyna & Greer, Scott L. & van Ginneken, Ewout, 2018. "Strategic Purchasing in Practice: Comparing Ten European Countries," Health Policy, Elsevier, vol. 122(5), pages 457-472.
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