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. 2024 Aug 1;34(4):632-638.
doi: 10.1093/eurpub/ckae060.

Disentangling the value equation: a step forward in value-based healthcare

Borja García-Lorenzo  1 , Itxaso Alayo  1 , Arantzazu Arrospide  2 , Ania Gorostiza  1 , Ane Fullaondo  1 ; VOICE Study Group
Collaborators, Affiliations

Disentangling the value equation: a step forward in value-based healthcare

Borja García-Lorenzo et al. Eur J Public Health. .

Abstract

Background: The value equation of value-based healthcare (VBHC) as a single figure remains ambiguous, closer to a theoretical framework than a useful tool for decision making. The challenge lies in the way patient-centred outcomes (PCOs) might be combined to produce a single value of the numerator. This paper aims to estimate the weights of PCOs to provide a single figure in the numerator, which ultimately will allow a VBHC figure to be reached.

Methods: A cohort of patients diagnosed with breast cancer (n = 690) with a 6-month follow-up recruited in 2019-20 across six European hospitals was used. Patient-reported outcomes (PROs), clinical-related outcomes (CROs), and clinical and socio-demographic variables were collected. The numerator was defined as a composite indicator of the PCOs (CI-PCO), and regression analysis was applied to estimate their weights and consequently arrive at a single figure.

Results: Pain showed as the highest weight followed by physical functioning, emotional functioning, and ability to work, and then by a symptom, either arm or breast. PCOs weights were robust to sensitivity analysis. The CI-PCO value was found to be more informative than the health-related quality of life (HRQoL) value.

Conclusions: To the best of our knowledge, this is the first research to combine the PCOs proposed by ICHOM to provide a single figure in the numerator of the value equation. This figure shows a step forward in VBHC to reach a holistic benchmarking across healthcare centres and a value-based payment. This research might also be applied in other medical conditions as a methodological pathway.

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Figures

Figure 1
Figure 1
Patient-centred outcomes weights.
Figure 2
Figure 2
CI-PCO and HRQoL scatterplot.
See this image and copyright information in PMC

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