Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Feb 24:12:13.
doi: 10.4103/ijpvm.IJPVM_325_19. eCollection 2021.

Model for Value-based Policy-making in Health Systems

Lida Shams  1 , Ali Akbari Sari  2 , Shahram Yazdani  3 , Taha Nasiri  4   5
Affiliations
Review

Model for Value-based Policy-making in Health Systems

Lida Shams et al. Int J Prev Med. .

Abstract

Background: Values are at the heart of discussions related to policy-making and any kind of reforms in health systems. Despite wide recognition of its importance, the concept of value is still vague and the policy-making processes remain astray with respect to values. This study aims to provide a model of value-based policy-making and to explain the concept value and how it affects policy-making.

Methods: The main question of the current study is to explain the concept of value-based policy-making and developing a model, based on the explained concept. In this line, critical review method and Carnwell and Daly approach and using particular keywords related to stewardship, and searching databases were used. In the initial search, 739 studies were obtained, of which using targeted sampling method, 11 studies were finally selected. Then, in order to design and explain different aspects of the value concept in the health system and to develop a model, selected studies were criticized, and finally, the conceptual model of value is designed and explained.

Results: The concept of value and its effects, dimensions and its relation to principles, evidence and criteria were determined at different stages of the policy-making process. It was also revealed that value-based policy-making in a health system is contingent upon the realization of terminal values.

Conclusions: In the process of selecting the best policy option, it is necessary to identify the relationship between terminal, instrumental, criterion, and evidence to avoid deviating from the reference value framework in any country and to avoid blindly imitating other experiences in other countries.

Keywords: Ethical theory; health policy; reference values; research evidence.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Value ladder (developed by authors)
Figure 2
Figure 2
Type of relationship between values (developed by authors)
Figure 3
Figure 3
Relation between values, evidence, and criteria (developed by authors)
Figure 4
Figure 4
Classification of value in health policy (developed by authors)
Figure 5
Figure 5
From objectivity to subjectivity in value-based policy-making (developed by authors)
Figure 6
Figure 6
Value-based policy-making model (developed by authors)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Roberts M, Hsiao W, Berman P, Reich M. Getting Health Reform Right: A Guide to Improving Performance and Equity. Oxford University Press. 2008
    1. Nasiri T, Takian A, Yazdani S. Stewardship in health, designing a multi-layer meta model: A review article. Iran J Public Health. 2019;48:579–92. - PMC - PubMed
    1. Boffin N. Antwerp: Institute of Tropical Medicine; 2002. Stewardship of Health Systems: Review of the Literature.
    1. Shams L, Yazdani S, Takian A, Nasiri T. Multi-sectoral requirements of non-communicable diseases stewardship in Iran. Revista Publicando. 2018;5:1420–37.
    1. Manavi S, Manesh AO, Yazdani S, Shams L, Nasiri T, Shirvani A, et al. Model for implementing evidence based health care system in Iran. Iran J Public Health. 2013;42:758–66. - PMC - PubMed