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. 2023 May;36(2):109-118.
doi: 10.1177/09514848221100751. Epub 2022 May 16.

Who counts when health counts? A case-study of multi-stakeholder initiative to promote value-creation in Swedish healthcare

Leonard Tragl  1 , Carl Savage  1 , Magna Andreen-Sachs  1 , Mats Brommels  1
Affiliations

Who counts when health counts? A case-study of multi-stakeholder initiative to promote value-creation in Swedish healthcare

Leonard Tragl et al. Health Serv Manage Res. 2023 May.

Abstract

A European initiative to design a "medical information framework" conceptualised how multiple stakeholders join in collaborative networks to create innovations. It conveyed the ways in which value is created and captured by stakeholders. We applied those insights to analyse a multi-stakeholder initiative to promote improvement of Swedish healthcare. Our longitudinal case study covered totally fifty stakeholders involved in a national project, aiming at designing a system to support value-based evaluation and reimbursement. During the project the focus changed from reimbursement to benchmarking. Sophisticated case-mix adjusting algorithms were designed to make outcome comparisons valid and incorporated in a software platform enabling detailed analysis of eight patient groups across seven regional health authorities. Those were deliverables demonstrating value created. However, the project was unable to transfer the system into routine use in the regions, a failed value-capture. The initial success was promoted by collaborative processes in diagnosis-specific working groups of well-informed and engaged professionals. The change of focus away from reimbursement decreased the involvement among health authorities, leaving no centrally placed persons to push for implementation. It highlights the importance of health professionals as the key stakeholder, who has both the know-how instrumental to creating an innovation, and the local involvement guaranteeing its implementation.

Keywords: collaboration, networks; health care; innovations; multi-stakeholder; value-based healthcare.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Schematic framework of stakeholder network.
Figure 2.
Figure 2.
Timeline of key project events.
See this image and copyright information in PMC

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