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دانلود رایکان مقاله انگلیسی ISI با موضوع خرید راهبردی در استونی

عنوان فارسی مقاله:

اصلاحات خرید راهبردی در استونی: کاهش نابرابری در دسترسی همزمان با افزایش تمرکز و کیفیت مراقبت

عنوان انگلیسی مقاله:

Strategic purchasing reform in Estonia: Reducing inequalities in access while improving care concentration and quality

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1. Introduction
The Health Insurance Act stipulates that the Estonian Health Insurance Fund (EHIF), the core purchaser of health services in Estonia, is not obliged to contract all health care providers operating in Estonia. Since 2002 the EHIF has developed a transparent contracting process and introduced criteria for selecting the best providers in terms of quality and cost [1]. Health care providers are contracted for at least three-years. The last contract cycle for inpatient and outpatient specialist as well as nursing care ended in the first quarter of 2014. This provided an opportunity to revise the selective contracting criteria so that they would better respond to changes in the health care delivery system and population needs, but also to further prioritize providers with a higher quality of care. The changes needed to address the increasing role of family medicine based primary care with a gradual increase of gatekeeping and coordinating prevention and care [2]; the concentration of higher level specialist care; and an increased capacity of the Hospital Network Development Plan (HNDP) hospitals due to the EU structural funds investments. Unsurprisingly, these developments have had signifi- cant repercussions for the EHIF’s strategic purchasing policy.

1. مقدمه