wow-inequalities/02-data/intermediate/wos_sample/af5c34fdb04732ea5d252aa52b96dd4b-yip-winnie-and-hans/info.yaml

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abstract: 'Objectives - Purchasing has been promoted as a key policy instrument to
improve health system performance. Despite its widespread adoption,
there is little empirical evidence on how it works, the challenges
surrounding its implementation, its impact, and the preconditions for it
to function effectively, particularly in low- and middle-income
settings. The objective of this chapter is to analyze critically the
extent to which purchasing could be, and has been used strategically in
China and to identify modifications that are needed for purchasing to be
effective in assuring that the government''s new funding for health care
will result in efficient and effective health services.
Methods - We present a conceptual framework for purchasing, which
identifies three critical principal-agent relationships in purchasing.
We draw on evidence from secondary data, results of other research
studies, interviews, and the impact evaluation of a social experiment in
rural China that explicitly used purchasing to improve quality and
efficiency. This information is used to examine purchasing relationships
in urban social health insurance (SHI), the rural medical insurance
scheme, and purchasing of public health services.
Findings - To date, use of strategic purchasing is limited in China.
Both the urban and the rural health insurance schemes act as passive
third-party payers, failing to take advantage of the opportunities to
strengthen incentives to improve quality and efficiency. This may be
because as government agencies, the extent to which the Ministries of
Health and Labor and Social Security can act independently from provider
interests, or act in the best interest of the population, is unclear.
Other important challenges include ensuring adequate representation of
the population''s views and preferences and making better use of the
leverage provided by purchasing to create appropriate provider
incentives, through better integration of financing and improved
coordination among purchasers.
Implications for policy - In designing purchasing arrangements,
attention needs to be paid to all three principal agent relationships.
Successful purchasing appears to require mechanisms to mobilize and
represent community preferences and more strategic contracting with
providers. More research is needed to strengthen the evidence on which
purchasing arrangements work, which no not work, and under what
conditions different purchasing configurations can work most
effectively.'
affiliation: 'Yip, W (Corresponding Author), Univ Oxford, Dept Publ Hlth, Hlth Econ
Res Ctr, Oxford, England.
Yip, Winnie, Univ Oxford, Dept Publ Hlth, Hlth Econ Res Ctr, Oxford, England.
Hanson, Kara, London Sch Hyg \& Trop Med, Dept Publ Hlth \& Policy, Hlth Econ \&
Financing Programme, London WC1, England.'
author: Yip, Winnie and Hanson, Kara
author_list:
- family: Yip
given: Winnie
- family: Hanson
given: Kara
booktitle: 'INNOVATIONS IN HEALTH SYSTEM FINANCE IN DEVELOPING AND TRANSITIONAL
ECONOMIES'
da: '2023-09-28'
doi: 10.1108/S0731-2199(2009)0000021011
editor: Chernichovsky, D and Hanson, K
files: []
isbn: 978-1-84855-664-5
issn: 0731-2199
keywords-plus: DEVELOPING-COUNTRIES; SYSTEM
language: English
number-of-cited-references: '26'
pages: 197-218
papis_id: 919792f70852dd5e76d295044a77fafd
ref: Yip2009purchasinghealth
series: Advances in Health Economics and Health Services Research
times-cited: '15'
title: 'PURCHASING HEALTH CARE IN CHINA: EXPERIENCES, OPPORTUNITIES AND CHALLENGES'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000270909400009
usage-count-last-180-days: '0'
usage-count-since-2013: '16'
volume: '21'
web-of-science-categories: Economics; Health Policy \& Services
year: '2009'