Active Purchasing: Empirical Insights From the Dutch Healthcare System and Lessons for Low- and Middle-Income Countries; Comment on “Measuring Active Purchasing in Healthcare: Analysing Reallocations of Funds Between Providers to Evaluate Purchasing Systems Performance in the Netherlands”

Articles in Press

Document Type : Commentary

Authors

1 Health, Nutrition, and Population Global Practice, World Bank Group, Washington, DC, USA

2 Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA

3 Evans School of Public Policy and Governance, University of Washington, Seattle, WA, USA

Abstract

Stadhouders et al critically examines the assumptions behind managed competition, revealing that competitive systems alone may not drive efficiency gains through fund reallocation. Their findings from the Dutch hospital sector suggest limited or low reallocation of funds between providers and highlight the need for monitoring resource allocation progress, understanding barriers and adjusting incentives for better functioning healthcare markets. For low- and middle-income countries (LMICs) undergoing health reforms, the Dutch experience underscores the importance of tailoring purchasing models to local contexts. LMICs should enhance data use for more strategic decision-making as well as building regulatory framework and institutional capacity for stronger implementation. Future research should explore how purchasing models interact with diverse health system characteristics to inform system-specific reforms. 

Keywords

References

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International Journal of Health Policy and Management

Articles in Press, Corrected Proof
Available Online from 12 July 2025

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History

  • Received Date: 18 April 2025
  • Revised Date: 18 June 2025
  • Accepted Date: 09 July 2025
  • First Published Date: 12 July 2025

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