Improving the quality of chronic care through purchasing arrangements in resource-constrained settings: insights from an international Delphi survey
Background There are substantial issues with the quality of care (QoC) received by persons living with chronic conditions, particularly in low- and middle-income countries (LMICs). One possible channel to improve QoC is through financing, specifically purchasing arrangements for health services. Thi...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Global Health Action |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/16549716.2025.2518667 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1839635026540494848 |
|---|---|
| author | Bruno Meessen Megumi Rosenberg Grace Marie V. Ku |
| author_facet | Bruno Meessen Megumi Rosenberg Grace Marie V. Ku |
| author_sort | Bruno Meessen |
| collection | DOAJ |
| description | Background There are substantial issues with the quality of care (QoC) received by persons living with chronic conditions, particularly in low- and middle-income countries (LMICs). One possible channel to improve QoC is through financing, specifically purchasing arrangements for health services. This has been actively explored in high-income country settings, generating a growing body of scientific knowledge. Objective To understand the potential and the constraints of using purchasing arrangements as a way to improve QoC for chronic conditions in resource-constrained settings. Methods A Delphi survey was conducted with 49 international participants with content expertise in chronic care management, health financing, or both, and context expertise in resource-constrained settings including in Small Island Developing States or Fragile and Conflict-Affected States, to assess the possible contribution of purchasing arrangements to QoC for chronic conditions with respect to specific types of care providers (e.g. patients and relatives, community health workers, public health centres), decentralized coordination bodies and purchasing agencies in such settings. Results There was a high level of consensus among the Delphi panel in favour of considering purchasing arrangements as one of the levers to improve QoC for people living with chronic conditions. Specific directions for action were identified along with their caveats. Conclusions The challenge of improving the quality of chronic care in resource-constrained settings is extensive and requires immediate attention. Leveraging purchasing arrangements is one promising channel to strengthen quality chronic care in such settings. |
| format | Article |
| id | doaj-art-033d2c0c43da47c8a7e19f3d9a27a89c |
| institution | Matheson Library |
| issn | 1654-9880 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj-art-033d2c0c43da47c8a7e19f3d9a27a89c2025-07-09T13:40:42ZengTaylor & Francis GroupGlobal Health Action1654-98802025-12-0118110.1080/16549716.2025.25186672518667Improving the quality of chronic care through purchasing arrangements in resource-constrained settings: insights from an international Delphi surveyBruno Meessen0Megumi Rosenberg1Grace Marie V. Ku2World Health OrganizationWorld Health OrganizationInstitute of Tropical MedicineBackground There are substantial issues with the quality of care (QoC) received by persons living with chronic conditions, particularly in low- and middle-income countries (LMICs). One possible channel to improve QoC is through financing, specifically purchasing arrangements for health services. This has been actively explored in high-income country settings, generating a growing body of scientific knowledge. Objective To understand the potential and the constraints of using purchasing arrangements as a way to improve QoC for chronic conditions in resource-constrained settings. Methods A Delphi survey was conducted with 49 international participants with content expertise in chronic care management, health financing, or both, and context expertise in resource-constrained settings including in Small Island Developing States or Fragile and Conflict-Affected States, to assess the possible contribution of purchasing arrangements to QoC for chronic conditions with respect to specific types of care providers (e.g. patients and relatives, community health workers, public health centres), decentralized coordination bodies and purchasing agencies in such settings. Results There was a high level of consensus among the Delphi panel in favour of considering purchasing arrangements as one of the levers to improve QoC for people living with chronic conditions. Specific directions for action were identified along with their caveats. Conclusions The challenge of improving the quality of chronic care in resource-constrained settings is extensive and requires immediate attention. Leveraging purchasing arrangements is one promising channel to strengthen quality chronic care in such settings.http://dx.doi.org/10.1080/16549716.2025.2518667quality of care for chronic conditions |
| spellingShingle | Bruno Meessen Megumi Rosenberg Grace Marie V. Ku Improving the quality of chronic care through purchasing arrangements in resource-constrained settings: insights from an international Delphi survey Global Health Action quality of care for chronic conditions |
| title | Improving the quality of chronic care through purchasing arrangements in resource-constrained settings: insights from an international Delphi survey |
| title_full | Improving the quality of chronic care through purchasing arrangements in resource-constrained settings: insights from an international Delphi survey |
| title_fullStr | Improving the quality of chronic care through purchasing arrangements in resource-constrained settings: insights from an international Delphi survey |
| title_full_unstemmed | Improving the quality of chronic care through purchasing arrangements in resource-constrained settings: insights from an international Delphi survey |
| title_short | Improving the quality of chronic care through purchasing arrangements in resource-constrained settings: insights from an international Delphi survey |
| title_sort | improving the quality of chronic care through purchasing arrangements in resource constrained settings insights from an international delphi survey |
| topic | quality of care for chronic conditions |
| url | http://dx.doi.org/10.1080/16549716.2025.2518667 |
| work_keys_str_mv | AT brunomeessen improvingthequalityofchroniccarethroughpurchasingarrangementsinresourceconstrainedsettingsinsightsfromaninternationaldelphisurvey AT megumirosenberg improvingthequalityofchroniccarethroughpurchasingarrangementsinresourceconstrainedsettingsinsightsfromaninternationaldelphisurvey AT gracemarievku improvingthequalityofchroniccarethroughpurchasingarrangementsinresourceconstrainedsettingsinsightsfromaninternationaldelphisurvey |