Strategic purchasing to improve health system performance: key issues and international trends.

Introduction All health systems exercise some form of purchasing, which, in its most basic form, constitutes the allocation of funds to provider organizations. When purchasing goes beyond the simple reimbursement of products and services and is aligned to societal healthcare needs and wishes, it has the potential to play a key role in determining a health system’s overall performance. However, no single organizational model of purchasing can, or should, be applied to all health systems. Purchasing arrangements must be determined chiefly by each country’s main form of healthcare funding and provision. Purchasing goes well beyond the mere contracting of providers. It includes the central role played by citizens and their Strategic Purchasing to Improve Health System Performance: Key Issues and International Trends