CENTRALIZATION AND CORRUPTION IN HEALTH PROCUREMENT OF THE SOUTHERN EUROPEAN UNION COUNTRIES

Healthcare procurement management in public hospitals has been a major concern for the countries of the Southern Europe, both due to their perennial problems in the field of corruption and the impact of increasing migration flows on the Mediterranean routes to the European Union. This study attempts to analyze the healthcare procurement systems of the Southern EU countries (EU MED or MED-9) based on the degree of centralization and perceived corruption and examine the applied procurement policies and their results in terms of efficiency, transparency, and competition. The MED-9 group consists of Cyprus, Croatia, France, Greece, Italy, Malta, Portugal, Slovenia, and Spain. The study employed an analytical research design and was conducted in two phases. In the first phase, data regarding the model of health system and the type of healthcare procurement of MED-9 countries based on the degree of centralization were collected using a comprehensive documentation review. In the second phase, seven different corruption perception indices in the public procurement and healthcare sector were collected, recorded, processed and compared to validate findings from the first phase and gain additional insights and feed-back regarding the relationship between centralized procurement and corruption. The study revealed significant differences in the healthcare procurement systems among the MED-9 countries, confirming that they vary due to their different organizational structure and socioeconomic choices. Our findings showed that there is a relationship between the degree of centralization and perceived corruption. Although Southern EU countries display relatively high levels of general corruption, some of them have significantly lower levels of perceived corruption in the specific areas of the healthcare system and public procurement. The study concludes that corruption is likely to decrease when purchasing processes are centralized. Healthcare procurement centralization through a central purchasing body can be an effective and powerful tool for cost reduction and fighting corruption in the public health sector.