Effective factors for strategic purchasing of health services in the field of cardiovascular diseases: A qualitative study

High prevalence of cardiovascular diseases has increased treatment costs. Strategic purchasing of health services provides a fair access to health services, financial risk protection, and effective management of the underlying risk factors for cardiovascular diseases. This study aims to identify the factors affecting the strategic purchasing of cardiovascular health services in Iran.

This qualitative study was conducted in 2020. In the first stage, a literature review and, in the second stage, the semi-structured interview tools were used for the data collection. The study population consisted of managers and policy-makers of the basic health insurance organizations, Ministry of Health, hospital administrators, faculty specialists, and cardiologists. The research sample was selected by targeted sampling method. The sample size of the research continued until theoretical saturation (12 people). Data were analyzed by content analysis method using MAXQDA.

Factors of Stewardship and policy-making, insurance, financial, structural, effective social factors for health, providers, patient-related factors, and political behavior of stakeholders influence the strategic purchasing of cardiovascular health services.

Due to the limited resources of the health system and the unlimited requirements of society, a strategic approach toward preventive interventions and the social determinants of health in terms of developing a basic insurance benefit packages can reduce the costs and quality of cardiovascular health care. Strategic purchasing requires the involvement and comprehensive support of stakeholders and key players in the health system.