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Is strategic purchasing feasible in publicly
funded health systems with integrated
purchasing and provision functions?
Di McIntyre
Health Economics Unit, University of Cape Town
iHEA, Milan; Tuesday 14 July, 2015
Clarifying concepts
• Purchasing is the critical link between resources
mobilised for universal coverage and the effective
delivery of quality services
• “Passive purchasing implies following a
predetermined budget or simply paying bills when
presented. Strategic purchasing involves a
continuous search for the best ways to maximize
health system performance by deciding which
interventions should be purchased, how, and from
whom.” (World Health Report 2000)
Conceptual framework
‘Ideal’ strategic purchasing
Methodological approach
• Explored each of the three principal-agent
relationships within integrated tax-funded
systems
• Compared ‘ideal’ with design (policy) with
actual practice and factors influencing this
• Qualitative methods:
• Document reviews, interviews, FGDs
• With government, purchasers, providers and
communities
www.wpro.who.int/asia_pacific_observatory
http://resyst.lshtm.ac.uk
@RESYSTresearch
The research is a collaboration between RESYST and the Asia
Pacific Observatory on Health Systems and Policies.
RESYST is funded by UK aid from the UK Department
for International Development (DFID). However, the
views expressed do not necessarily reflect the
Department’s official policies.
More information: http://resyst.lshtm.ac.uk/research-projects/
multi-country-purchasing-study
www.wpro.who.int/asia_pacific_observatory
http://resyst.lshtm.ac.uk
@RESYSTresearch
The research is a collaboration between RESYST and the Asia
Pacific Observatory on Health Systems and Policies.
RESYST is funded by UK aid from the UK Department
for International Development (DFID). However, the
views expressed do not necessarily reflect the
Department’s official policies.
More information: http://resyst.lshtm.ac.uk/research-projects/
multi-country-purchasing-study

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Is strategic purchasing feasible in publicly funded health systems with integrated purchasing and provision functions?

  • 1. Is strategic purchasing feasible in publicly funded health systems with integrated purchasing and provision functions? Di McIntyre Health Economics Unit, University of Cape Town iHEA, Milan; Tuesday 14 July, 2015
  • 2. Clarifying concepts • Purchasing is the critical link between resources mobilised for universal coverage and the effective delivery of quality services • “Passive purchasing implies following a predetermined budget or simply paying bills when presented. Strategic purchasing involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, how, and from whom.” (World Health Report 2000)
  • 5. Methodological approach • Explored each of the three principal-agent relationships within integrated tax-funded systems • Compared ‘ideal’ with design (policy) with actual practice and factors influencing this • Qualitative methods: • Document reviews, interviews, FGDs • With government, purchasers, providers and communities
  • 6. www.wpro.who.int/asia_pacific_observatory http://resyst.lshtm.ac.uk @RESYSTresearch The research is a collaboration between RESYST and the Asia Pacific Observatory on Health Systems and Policies. RESYST is funded by UK aid from the UK Department for International Development (DFID). However, the views expressed do not necessarily reflect the Department’s official policies. More information: http://resyst.lshtm.ac.uk/research-projects/ multi-country-purchasing-study
  • 7. www.wpro.who.int/asia_pacific_observatory http://resyst.lshtm.ac.uk @RESYSTresearch The research is a collaboration between RESYST and the Asia Pacific Observatory on Health Systems and Policies. RESYST is funded by UK aid from the UK Department for International Development (DFID). However, the views expressed do not necessarily reflect the Department’s official policies. More information: http://resyst.lshtm.ac.uk/research-projects/ multi-country-purchasing-study