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Respiratory diseases are becoming a major challenge in health systems as they cover expanding and diversified pathologies such as chronic obstructive pulmonary disease, chronic bronchitis, emphysema and other types increasing at a fast rate as it is the case of sleep apnoea. Nowadays, most of these pathologies can be treated by home respiratory care services using advanced medical equipment as well as efficient assistance and monitoring services supported by digital technologies. However, the implementation of home respiratory care services implies flexible public contracting of such services to achieve equity conditions of access and to cope with their technological nature, their continuous processes of innovation and their time dependent demand. Unfortunately, traditional procurement processes are not able to meet these challenges explaining their frequent low rates of success and so an alternative procurement approach is proposed in this paper based on an electronic quasi‐market model. This new model was successfully applied in Portugal and the evaluated results are also discussed herein.

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A major trend to improve Public Administration has been the increase of contracting out services hoping to achieve better levels of performance. However, the effectiveness and efficiency of this approach implies the application of appropriate models to evaluate such performance This is why a multi-criteria model was developed by the authors to evaluate and to improve the performance of public services contracts focusing on four key dimensions: the process of contract formation, the contract costs, the benefits achieved by the contract execution and its impacts. The proposed model provides a stable, consistent and integrated framework allowing not just the evaluation of contracts but also the identification of the priorities for improvement. A successful application to the evaluation of Home Respiratory Services is also presented.