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. 2021 Jun 29;66(5):340-365.
doi: 10.1097/JHM-D-20-00283.

Value-Based Healthcare Initiatives in Practice: A Systematic Review

Bruna Stella Zanotto  1 , Ana Paula Beck da Silva Etges  2 , Miriam Allein Zago Marcolino  3 , Carisi Anne Polanczyk  4
Affiliations

Value-Based Healthcare Initiatives in Practice: A Systematic Review

Bruna Stella Zanotto et al. J Healthc Manag. .

Abstract

Value-based initiatives are growing in importance as strategic models of healthcare management, prompting the need for an in-depth exploration of their outcome measures. This systematic review aimed to identify measures that are being used in the application of the value agenda. Multiple electronic databases (PubMed/MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials) were searched. Eligible studies reported various implementations of value-based healthcare initiatives. A qualitative approach was used to analyze their outcome measurements. Outcomes were classified according to a tier-level hierarchy. In a radar chart, we compared literature to cases from Harvard Business Publishing. The value agenda effect reported was described in terms of its impact on each domain of the value equation. A total of 7,195 records were retrieved; 47 studies were included. Forty studies used electronic health record systems for data origin. Only 16 used patient-reported outcome surveys to cover outcome tiers that are important to patients, and 3 reported outcomes to all 6 levels of our outcome measures hierarchy. A considerable proportion of the studies (36%) reported results that contributed to value-based financial outcomes focused on cost savings. However, a gap remains in measuring outcomes that matter to patients. A more complete application of the value agenda by health organizations requires advances in technology and culture change management.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA Diagram
FIGURE 2
FIGURE 2
Radar Chart of Literature and Cases Profile in Outcome Information Coverage
See this image and copyright information in PMC

Comment in

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