International Journal of Health Policy and Management

International Journal of Health Policy and Management

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”

Document Type : Commentary

Authors
Xiaohui Hou 1
Yanfang Su 2, 3
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
10.34172/ijhpm.9169
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
Active Purchasing
Strategic Purchasing
Managed Competition
Resource Allocation
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International Journal of Health Policy and Management
Volume 14, Issue 1
2025
Pages 1-4

  • Received Date 18 April 2025
  • Revised Date 18 June 2025
  • Accepted Date 09 July 2025
  • First Published Date 12 July 2025
  • Published Date 01 December 2025