Document Type : Original Article


1 Contributed equally to this work.

2 Contributed equally to this work Health Information Technology Research Center, Student Research Committee, Department of Medical Library and Information Sciences, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


BACKGROUND: Providing financial resources for health services is one of the most important issues
in the study of health systems, of which purchasing health services is very essential. The World
Health Organization considers strategic purchasing as a key option for improving the performance
of health systems. The aim of this study was to identify payment methods for service providers and
strategic purchasing strategies in upper middle income countries.
MATERIALS AND METHODS: The present study was conducted in the form of a comparative analysis
involving comprehensive surveys from 2000 to 2019, by searching keywords for the objective of
the study by the search engines through databases including ProQuest, PubMed, Google Scholar,
Irandoc, SID, Magiran, Science Direct, Scopus, ISI Web of Science, EBSCO, and Cochrane.
RESULTS: A total of five upper middle income countries that used strategic purchases entered the
study. Overall, all of them implemented rather similar strategies in terms of strategic purchasing and
paying to the providers of the services.
CONCLUSION: According to the results of this study, per capita payment for primary health‑care and
outpatient services seems to be the best option for controlling the costs of the health sector, while
the appropriate option for the inpatient department is the most common use of diagnosis‑related
group. The payment method is to control the costs of the inpatient department.


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