REVIEW

Is strategic purchasing the right strategy to improve a health system’s performance? A systematic review

Djavad Ghoddoosi-Nezhad, Ali Janati , Morteza Arab Zozani, Leila Doshmagir, Homayoun Sadeghi Bazargani, Ali Imani

Djavad Ghoddoosi-Nezhad
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, student research committee, Tabriz University of Medical Sciences, Tabriz, Iran

Ali Janati
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran. Email: [email protected]

Morteza Arab Zozani
Research center of modeling in health, institute for future studies in health, Kerman university of medical sciences, Kerman, Iran

Leila Doshmagir
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

Homayoun Sadeghi Bazargani
Road Trafc Injury Research Center, Department of Statistics & Epidemiology, Tabriz University of medical sciences, Tabriz, Iran

Ali Imani
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
Online First: February 18, 2017 | Cite this Article
Ghoddoosi-Nezhad, D., Janati, A., Arab Zozani, M., Doshmagir, L., Sadeghi Bazargani, H., Imani, A. 2017. Is strategic purchasing the right strategy to improve a health system’s performance? A systematic review. Bali Medical Journal 6(1): 102-113. DOI:10.15562/bmj.v6i1.369


Purpose: This study aims to systematically review and investigate the benefits and challenges of strategic purchasing implementation in health systems and suggests a basis for improving their performance.

Method: This is a systematic review in which electronic databases and search engines—including PubMed, Springer, OvidSP, ProQuest, Google scholar and Scopus, along with related journals, library, and grey literature—were searched for related articles from 1990 to 2015. Updates were added to the searches if found. Search strategies included the combination of two sets of keywords (“purchasing,” “contracting” OR “commissioning” OR “buying” OR “procurement”) with (“strategic” OR “active” OR “proactive”). Articles in English or Farsi, which discussed benefits and challenges of strategic purchasing in a health context, were eligible to be included in the study. Two researchers independently completed all steps of the research. Quality assessment of all included articles for final review were done using related checklists.

Results: 2049 records identified through searching databases, which were refined to 23 final articles. Based on the result of this study, the benefits of strategic purchasing implementation in health systems were reported as higher quality, higher efficiency, better value for money (VfM), while high administrative costs, issues in priority setting, a need for accurate information and political issues were among the main challenges and disadvantages.

Conclusion: Strategic purchasing can be a healthy useful option for every health system to adequately reach health system objectives.

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