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Abstract：
The management of health supplies in public hospitals has been a major concern of national and European institutions over time, often being a field of reforms and regulatory interventions. Health procurement systems constitute complex decision-making and supply chain management mechanisms of public hospitals, involving suppliers, health providers, administrators and political bodies. Due to this complexity, the first important decision to be taken when designing a procurement system, concerns the degree of centralization, namely to what extent the decision-making power on the healthcare procurement (what, how and when) will be transferred either to a central public authority established for this purpose, or to the competent local authorities. In this perspective, we attempt to analyse the types of public procurement in the healthcare sector of the European Union, in terms of degree of centralization. Employing a narrative approach that summarizes recent interdisciplinary literature, this perspective finds that the healthcare procurement systems of the EU Member States, based on the degree of centralization, are categorized into three types of organizational structures: Centralized, Decentralized and Hybrid procurement. Each structure offers advantages and disadvantages for health systems. According to this perspective, a combination of centralized and decentralized purchases of medical supplies represents a promising hybrid model of healthcare procurement organization by bringing the benefits of two methods together.
摘要：
公立医院卫生用品的管理一直是国家和欧洲机构关注的主要问题,通常是改革和监管干预的领域。卫生采购系统构成了公立医院复杂的决策和供应链管理机制,涉及供应商，健康提供者,管理者和政治机构。由于这种复杂性,设计采购系统时要做出的第一个重要决定，关于中央集权的程度，即医疗保健采购的决策权在多大程度上(什么，如何以及何时)将被移交给为此目的设立的中央公共机构，或地方主管当局。从这个角度来看,我们试图分析欧盟医疗保健部门的公共采购类型，就集中化程度而言。采用一种总结最近跨学科文献的叙事方法，这一观点发现，欧盟成员国的医疗保健采购系统，根据集中化的程度，分为三种类型的组织结构：集中式，分散和混合采购。每种结构都为卫生系统提供了优点和缺点。根据这个观点,通过将两种方法的好处结合在一起，集中和分散的医疗用品采购组合代表了一种有前途的医疗采购组织混合模式。
