La centralizzazione degli acquisti in sanità: Esperienze internazionali a confronto

Based on an analysis of national and international literature on consortia purchasing, the article investigates and compares centralized purchasing across four European Healthcare systems (United Kingdom, France, Switzerland and Spain). The case studies highlight the main characteristics in terms of institutional frameworks and operating mechanisms. All the European systems surveyed have promoted different forms of purchasing collaboration among healthcare organisations in order to reduce public expenditure and improve efficiency. However, there is a wide diversity of organizational solutions adopted, both at central and local/ regional level. The results show an evolving scenario, looking at balancing the need to contain the health care systems' overall costs and at preserving decision autonomy and accountability of healthcare organizations.