Challenges and Opportunities for Purchasing High-Quality Health Care : Lessons from Armenia

This paper examines how purchasing decisions in Armenia may contribute to barriers in using high-quality health care, particularly for non-communicable diseases, drawing on a review of the literature and key informant interviews. The paper adapts the strategic health purchasing progress framework, t...

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Main Authors:	Chukwuma, Adanna, Lylozian, Hratchia, Gong, Estelle
Format:	Journal Article
Published:	Taylor and Francis 2021
Subjects:	PRIMARY HEALTH CARE STRATEGIC PURCHASING UNIVERSAL HEALTH COVERAGE NONCOMMUNICABLE DISEASE ACCESS TO HEALTH SERVICES
Online Access:	http://hdl.handle.net/10986/35558

id	okr-10986-35558
recordtype	oai_dc
spelling	okr-10986-355582021-07-19T16:36:00Z Challenges and Opportunities for Purchasing High-Quality Health Care : Lessons from Armenia Chukwuma, Adanna Lylozian, Hratchia Gong, Estelle PRIMARY HEALTH CARE STRATEGIC PURCHASING UNIVERSAL HEALTH COVERAGE NONCOMMUNICABLE DISEASE ACCESS TO HEALTH SERVICES This paper examines how purchasing decisions in Armenia may contribute to barriers in using high-quality health care, particularly for non-communicable diseases, drawing on a review of the literature and key informant interviews. The paper adapts the strategic health purchasing progress framework, to examine how characteristics of purchasing, the health system, and the political, administrative, and macro-fiscal environment may have facilitated or hindered the attainment of service delivery goals. We conclude with six lessons for reforms aimed at improving the coverage and quality of health care in Armenia. First, increasing the political priority of access to quality of health care is a pre-requisite to advancing reforms to address these issues. Second, improved purchasing governance in Armenia will require a purchaser that can make decisions without political interference, with appropriate accountability mechanisms, improvements in technical capacity, and the routine use of data systems. Third, there is a need for the regulatory framework to ensure that revisions of the benefits package contribute to reducing the disease burden and improving access to care. Fourth, regulations governing quality-related criteria for provider selection should be enforced and include considerations for process quality. Fifth, payment incentives should be revised to encourage an increase in the supply of primary health care, reduce bypassing for hospital care, and improve the quality of services. Sixth, the potential of purchasing to improve service delivery will be dependent on increased pre-paid and pooled funds and better governance of the quality of care. 2021-05-12T18:19:51Z 2021-05-12T18:19:51Z 2021-04-29 Journal Article Health Systems and Reform http://hdl.handle.net/10986/35558 CC BY 4.0 http://creativecommons.org/licenses/by/4.0 World Bank Taylor and Francis Publications & Research :: Journal Article Publications & Research Europe and Central Asia Armenia
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
topic	PRIMARY HEALTH CARE STRATEGIC PURCHASING UNIVERSAL HEALTH COVERAGE NONCOMMUNICABLE DISEASE ACCESS TO HEALTH SERVICES
spellingShingle	PRIMARY HEALTH CARE STRATEGIC PURCHASING UNIVERSAL HEALTH COVERAGE NONCOMMUNICABLE DISEASE ACCESS TO HEALTH SERVICES Chukwuma, Adanna Lylozian, Hratchia Gong, Estelle Challenges and Opportunities for Purchasing High-Quality Health Care : Lessons from Armenia
geographic_facet	Europe and Central Asia Armenia
description	This paper examines how purchasing decisions in Armenia may contribute to barriers in using high-quality health care, particularly for non-communicable diseases, drawing on a review of the literature and key informant interviews. The paper adapts the strategic health purchasing progress framework, to examine how characteristics of purchasing, the health system, and the political, administrative, and macro-fiscal environment may have facilitated or hindered the attainment of service delivery goals. We conclude with six lessons for reforms aimed at improving the coverage and quality of health care in Armenia. First, increasing the political priority of access to quality of health care is a pre-requisite to advancing reforms to address these issues. Second, improved purchasing governance in Armenia will require a purchaser that can make decisions without political interference, with appropriate accountability mechanisms, improvements in technical capacity, and the routine use of data systems. Third, there is a need for the regulatory framework to ensure that revisions of the benefits package contribute to reducing the disease burden and improving access to care. Fourth, regulations governing quality-related criteria for provider selection should be enforced and include considerations for process quality. Fifth, payment incentives should be revised to encourage an increase in the supply of primary health care, reduce bypassing for hospital care, and improve the quality of services. Sixth, the potential of purchasing to improve service delivery will be dependent on increased pre-paid and pooled funds and better governance of the quality of care.
format	Journal Article
author	Chukwuma, Adanna Lylozian, Hratchia Gong, Estelle
author_facet	Chukwuma, Adanna Lylozian, Hratchia Gong, Estelle
author_sort	Chukwuma, Adanna
title	Challenges and Opportunities for Purchasing High-Quality Health Care : Lessons from Armenia
title_short	Challenges and Opportunities for Purchasing High-Quality Health Care : Lessons from Armenia
title_full	Challenges and Opportunities for Purchasing High-Quality Health Care : Lessons from Armenia
title_fullStr	Challenges and Opportunities for Purchasing High-Quality Health Care : Lessons from Armenia
title_full_unstemmed	Challenges and Opportunities for Purchasing High-Quality Health Care : Lessons from Armenia
title_sort	challenges and opportunities for purchasing high-quality health care : lessons from armenia
publisher	Taylor and Francis
publishDate	2021
url	http://hdl.handle.net/10986/35558
_version_	1764483284113293312

Challenges and Opportunities for Purchasing High-Quality Health Care : Lessons from Armenia

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