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Related Experiment Videos

Quality-based purchasing in health care.

Hugh R Waters1, Laura L Morlock, Laurel Hatt

  • 1Johns Hopkins Bloomberg School of Public Health, Baltimore 21205, USA. hwaters@jhsph.edu

The International Journal of Health Planning and Management
|February 4, 2005
PubMed
Summary

Quality-based purchasing enhances healthcare by focusing on the purchaser-provider relationship. Information availability is crucial for monitoring performance and improving healthcare quality globally.

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Area of Science:

  • Health Services Research
  • Health Economics
  • Public Health Policy

Background:

  • Quality-based purchasing is an emerging strategy to improve healthcare quality.
  • It emphasizes the relationship between purchasers and providers of healthcare services.
  • Healthcare spending and purchasing mechanisms evolve with a country's economic status.

Purpose of the Study:

  • To present a unifying conceptual framework for quality-based purchasing.
  • To provide examples of purchaser-provider relationships across different income levels.
  • To identify key supporting mechanisms for effective quality-based purchasing.

Main Methods:

  • Conceptual framework development.
  • Cross-country comparative analysis of healthcare purchasing models.

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  • Identification and synthesis of supporting mechanisms for quality improvement.

    • Main Results:

    • Healthcare purchasing power increases with national wealth, enabling greater quality focus.
    • Low- and middle-income countries often use global/line item budgets, facing challenges in public hospital performance improvement.
    • High-income countries show success in contracting with private providers for better quality and lower costs.
    • Employer purchasing arrangements and community-based financing are explored, with limited evidence on the latter's impact on quality.
    • Information availability on service provision and outcomes is a critical determinant for quality-based purchasing.

    Conclusions:

    • Quality-based purchasing is adaptable across diverse economic contexts.
    • Effective implementation hinges on robust information systems for monitoring and consumer guidance.
    • Lack of data is a significant barrier to performance measurement and quality improvement in many low- and middle-income countries.