Sustainable purchases

V Congreso de
Sustainable purchases for
Economía de la Salud sustainable health systems.
de América Latina y el Caribe

Lic. Ariel Goldman
Salud, protección social y desarrollo Universidad de Buenos Aires
económico: el desafío de la
sustentabilidad de los sistemas Argentina
sanitarios
English version: Contadora
Teresita C. Durañona Sanabria

14, 15 y 16 de noviembre de 2012

V Congreso de Economía de la Salud de América Latina y el Caribe

Research Objectives
Evaluate the diverse purchasing processes affecting the public
hospitals from these points of view: transparency, efficiency,
opportunity and budget control.
Research Limitations
• Public system – Legality
• We considered the National law and the Buenos Aires city
one (there is one per province in the Argentine system plus
the National one)
• Supplies and non-personal services acquisition
Research Methodology
• Qualitative field research with personal interviews.
• Quantitative data analysis.



Objectives of governmental purchasing system

Transparency: as a public sector it should ensure that acts which
are done are clear, free of doubts about bribes and corruption.

Efficiency: This point has a double meaning, on one hand the
issue of cost / benefit that generates more controls during the
purchase process, and on the other hand, achieve efficiency in
the spending, getting the input according to the market value,
the way of payment, quantity, etc.



Objectives of governmental purchasing system

Opportunity: It is achieved by acquiring inputs and services in
proper time. Thus, the purchasing process ensures the fairness of
the system, which means the same response to the same need,
avoiding health inequalities generated by economic access
problems.

Budget Control: It must be kept a tight and strict control on the
spending to avoid compromising the exchequer without budget
support.
Complex system with objectives that contrast themselves



Results
Processes Virtues Deficiencies Observations
analyzed

Competitive Transparency Efficiency Supply of
tendering or bid Budget Control common and
in the hospital Opportunity normal inputs

Acquisition Efficiency Transparency Overuse
through Opportunity Budget Control
emergency
mechanisms
Petty Cash Efficiency Transparency Limited in
amount. Not
always available


Resultados
Processes Virtues Deficiencies Observations
analyzed

Purchases Budget Control Opportunity Uncertainty
through the Efficiency
Health Ministry
with stock
Purchases Efficiency Opportunity Problems for
through the Budget Control
Health Ministry Opportunity
single
without stock supplier.
Different
results



Conclusions
• It doesn't exist a single ideal process, considering that in the
practice all of them show their virtues and deficiencies.

• The causes of the deficiencies are multiple, they involve all the
participants and the revision of the regulatory. It is necessary to
have a specific set of purchases processes for health.

• The health system is an "intensive labor system" where the 70%
of the budget are salaries. The emphasis in the purchasing system
is on the public expenditure control, suffering a lack of cost control
per patient



Conclusions
• There are necessary and relevant instruments to improve
processes regardless the method chose. Ex: Registration of
suppliers, supplies catalogs, etc.

•There isn't a discussion on critical issues such as minimum quality
standard or stock management.

•New trends:
- Green Purchases (included in the new National law since
August 2012)
- Electronic purchases



Thank You


Sustainable purchases

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