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Ziehfreund S, Wecker H, Mittag S, Weis J, Tizek L, Verkhoturova V, Legat FJ, Weger W, Großschädl K, Cerpes U, Sadoghi B, Riegler M, Balato A, Di Brizzi EV, Buononato D, Babino G, Calzavara-Pinton P, Rossi MT, Rovaris S, Dimech A, Boffa MJ, Chernyshov P, Svyatenko T, Kolodzinska L, Sikora M, Torres T, Manolache L, Scala E, Biedermann T, Zink A. Happiness across the borders-A cross-sectional study among patients with psoriasis and atopic dermatitis in Europe. J Eur Acad Dermatol Venereol 2024. [PMID: 39140310 DOI: 10.1111/jdv.20288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 07/11/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Dermatological research has traditionally concentrated on evaluating mental comorbidities, neglecting positive concepts like happiness. Initial studies indicate that psoriasis and atopic dermatitis (AD) impair the happiness of those affected. Considering global happiness variations, this study aimed to explore the disease- and country-specific differences in disease-related quality of life and happiness, and potential influential factors on heuristic happiness among psoriasis and AD patients in Europe. METHODS A cross-sectional multicentre study was conducted in dermatology departments of university-affiliated hospitals in eight European countries (Austria, Germany, Italy, Malta, Poland, Portugal, Romania and Ukraine) between October 2021 and February 2023. Adult psoriasis and AD patients completed a standardized questionnaire in their native languages, providing data on demographics, disease-related characteristics, disease-related quality of life (Dermatology Life Quality Index, DLQI), heuristic happiness, positive affect (PA), negative affect (NA) and satisfaction with life (SWL). Descriptive analysis and quantile regression were performed. RESULTS Between psoriasis (n = 723) and AD (n = 316) patients almost no differences were observed in happiness, SWL and NA, except for DLQI and small differences in PA, with AD patients reporting greater impact than psoriasis patients. Country-wise variation emerged in DLQI, heuristic happiness, PA, NA and SWL with Austrian patients displaying the highest levels of happiness, satisfaction and positivity, coupled with higher treatment care and lower disease severity. Quantile regression revealed varying coefficients for predictor variables across quantiles, indicating, for example positive effects on heuristic happiness associated with current or previous receipt of systemic therapies at different quantiles. CONCLUSION This study shows notable happiness differences across European countries and significant disease-related variations, particularly with AD patients being more impaired than psoriasis patients. The findings highlight the need for equality in treatment access and support the development of targeted positive psychological interventions to enhance happiness considering country-specific distinctions in future research and health policies for psoriasis and AD patients.
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Affiliation(s)
- S Ziehfreund
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - H Wecker
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - S Mittag
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - J Weis
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - L Tizek
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - V Verkhoturova
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - F J Legat
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - W Weger
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - K Großschädl
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - U Cerpes
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - B Sadoghi
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - M Riegler
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - A Balato
- Unit of Dermatology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - E V Di Brizzi
- Unit of Dermatology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - D Buononato
- Unit of Dermatology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Babino
- Unit of Dermatology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - P Calzavara-Pinton
- Dermatology Department, University and ASST Spedali Civili, Brescia, Italy
| | - M T Rossi
- Dermatology Department, University and ASST Spedali Civili, Brescia, Italy
| | - S Rovaris
- Dermatology Department, University and ASST Spedali Civili, Brescia, Italy
| | - A Dimech
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - M J Boffa
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - P Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - T Svyatenko
- Department of Skin and Venereal Diseases, Dnipro State Medical University, Dnipro, Ukraine
| | - L Kolodzinska
- Khmelnytskyi City Medical and Diagnostic Center, 2nd Polyclinic, Khmelnytskyi, Ukraine
| | - M Sikora
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - T Torres
- Department of Dermatology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Instituto de Ciências biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - E Scala
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Biedermann
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - A Zink
- TUM School of Medicine and Health, Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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García-Lorenzo B, Alayo I, Arrospide A, Gorostiza A, Fullaondo A. Disentangling the value equation: a step forward in value-based healthcare. Eur J Public Health 2024; 34:632-638. [PMID: 38878265 PMCID: PMC11293829 DOI: 10.1093/eurpub/ckae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024] Open
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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Affiliation(s)
- Borja García-Lorenzo
- Biosistemak Institute for Health Systems Research, Torre del Bilbao Exhibition Centre, Barakaldo, Basque Country, Spain
| | - Itxaso Alayo
- Biosistemak Institute for Health Systems Research, Torre del Bilbao Exhibition Centre, Barakaldo, Basque Country, Spain
| | | | - Ania Gorostiza
- Biosistemak Institute for Health Systems Research, Torre del Bilbao Exhibition Centre, Barakaldo, Basque Country, Spain
| | - Ane Fullaondo
- Biosistemak Institute for Health Systems Research, Torre del Bilbao Exhibition Centre, Barakaldo, Basque Country, Spain
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Gongora-Salazar P, Perera R, Rivero-Arias O, Tsiachristas A. Unravelling Elements of Value of Healthcare and Assessing their Importance Using Evidence from Two Discrete-Choice Experiments in England. PHARMACOECONOMICS 2024:10.1007/s40273-024-01416-5. [PMID: 39085565 DOI: 10.1007/s40273-024-01416-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/07/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Health systems are moving towards value-based care, implementing new care models that allegedly aim beyond patient outcomes. Therefore, a policy and academic debate is underway regarding the definition of value in healthcare, the inclusion of costs in value metrics, and the importance of each value element. This study aimed to define healthcare value elements and assess their relative importance (RI) to the public in England. METHOD Using data from 26 semi-structured interviews and a literature review, and applying decision-theory axioms, we selected a comprehensive and applicable set of value-based elements. Their RI was determined using two discrete choice experiments (DCEs) based on Bayesian D-efficient DCE designs, with one DCE incorporating healthcare costs expressed as income tax rise. Respondent preferences were analysed using mixed logit models. RESULTS Six value elements were identified: additional life-years, health-related quality of life, patient experience, target population size, equity, and cost. The DCE surveys were completed by 402 participants. All utility coefficients had the expected signs and were statistically significant (p < 0.05). Additional life-years (25.3%; 95% confidence interval [CI] 22.5-28.6%) and patient experience (25.2%; 95% CI 21.6-28.9%) received the highest RI, followed by target population size (22.4%; 95% CI 19.1-25.6%) and quality of life (17.6%; 95% CI 15.0-20.3%). Equity had the lowest RI (9.6%; 95% CI 6.4-12.1%), decreasing by 8.8 percentage points with cost inclusion. A similar reduction was observed in the RI of quality of life when cost was included. CONCLUSION The public prioritizes value elements not captured by conventional metrics, such as quality-adjusted life-years. Although cost inclusion did not alter the preference ranking, its inclusion in the value metric warrants careful consideration.
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Affiliation(s)
- Pamela Gongora-Salazar
- Social Protection and Health Division, Inter-American Development Bank, Washington, DC, USA.
- Nuffield Department of Population Health, Health Economics Research Centre (HERC), University of Oxford, Oxford, UK.
| | - Rafael Perera
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Oliver Rivero-Arias
- Nuffield Department of Population Health, Health Economics Research Centre (HERC), University of Oxford, Oxford, UK
- Nuffield Department of Population Health, National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, England, UK
| | - Apostolos Tsiachristas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
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van Zwol-Janssens C, Jiskoot G, Schipper J, Louwers YV. Introducing a value-based healthcare approach for women with premature ovarian insufficiency (POI): Recommendations for patient-centered outcomes in clinical practice. Maturitas 2024; 184:107971. [PMID: 38492525 DOI: 10.1016/j.maturitas.2024.107971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/27/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE To establish a set of clinician and patient-reported outcome measures (PROMs) and present the initial findings of a value-based healthcare (VBHC) program in patients with premature ovarian insufficiency (POI). METHODS Employing a four-phase approach, we identified the most crucial domains for patients with POI and translated these into PROMs. Prior to each visit, patients completed questionnaires to evaluate: depression (BDI-II), menopausal symptoms (GCS), work ability (WAS) and infertility (FertiQoL). During the visits, cardiovascular health assessments and dual-energy X-ray absorptiometry (DEXA) scans to measure bone mineral density were performed. Data at intake is presented, and comparisons are drawn between women using and those not using hormone replacement therapy (HRT). Patient-reported experience measures (PREMs) were evaluated by a questionnaire. RESULTS A total of 267 POI patients completed the PROM questionnaires, of whom 58.1 % were using HRT at intake. Over half of the patients (53.5 %), had a BDI-II score of 14 or higher, indicating mild to severe depression. The mean total GCS score was 20.9 (SD 11.3). The median work ability score was 7.5 (IQR 6.0-8.0) and the mean FertiQoL score 63.9 (SD 15.7). Additionally, 22.7 % of patients presented with hypertension, 6.2 % with hypercholesterolemia, and almost 50 % had low bone mass. Patients rated the VBHC program with a mean of 8.6 (SD 1.2). CONCLUSIONS These findings underscore the necessity of a multidisciplinary VBHC program incorporating standardized screening and psychological treatment. We advocate for the implementation of patient-centered outcomes for clinical practice, which have been found to be highly relevant by patients with POI.
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Affiliation(s)
- Charissa van Zwol-Janssens
- Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, the Netherlands.
| | - Geranne Jiskoot
- Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, the Netherlands; Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, the Netherlands
| | - Jits Schipper
- Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, the Netherlands
| | - Yvonne V Louwers
- Division Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, the Netherlands
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van der Poort EKJ, Kidanemariam M, Moriates C, Rakers MM, Tsevat J, Schroijen M, Atsma DE, van den Akker-van Marle ME, Bos WJW, van den Hout WB. How to Use Costs in Value-Based Healthcare: Learning from Real-life Examples. J Gen Intern Med 2024; 39:683-689. [PMID: 38135776 DOI: 10.1007/s11606-023-08423-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/07/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Healthcare organizations measure costs for business operations but do not routinely incorporate costs in decision-making on the value of care. AIM Provide guidance on how to use costs in value-based healthcare (VBHC) delivery at different levels of the healthcare system. SETTING AND PARTICIPANTS Integrated practice units (IPUs) for diabetes mellitus (DM) and for acute myocardial infarction (AMI) at the Leiden University Medical Center and a collaboration of seven breast cancer IPUs of the Santeon group, all in the Netherlands. PROGRAM DESCRIPTION AND EVALUATION VBHC aims to optimize care delivery to the patient by understanding how costs relate to outcomes. At the level of shared decision-making between patient and clinician, yearly check-up consultations for DM type I were analyzed for patient-relevant costs. In benchmarking among providers, quantities of cost drivers for breast cancer care were assessed in scorecards. In continuous learning, cost-effectiveness analysis was compared with radar chart analysis to assess the value of telemonitoring in outpatient follow-up. DISCUSSION Costs vary among providers in healthcare, but also between provider and patient. The joint analysis of outcomes and costs using appropriate methods helps identify and optimize the aspects of care that drive desired outcomes and value.
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Affiliation(s)
- Esmée K J van der Poort
- Department of Biomedical Data Sciences, Section of Medical Decision-Making, Leiden University Medical Center, Leiden, The Netherlands.
| | - Martha Kidanemariam
- Department of Biomedical Data Sciences, Section of Medical Decision-Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Christopher Moriates
- Department of Internal Medicine, Dell Medical School, University of Texas, Austin, TX, USA
- Department of Medical Education, Dell Medical School, University of Texas, Austin, TX, USA
| | - Margot M Rakers
- National eHealth Living Lab, Leiden University Medical Center, Leiden, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Joel Tsevat
- Department of Medicine and ReACH Center, Joe R. & Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Marielle Schroijen
- Department of Internal Medicine, Section of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Douwe E Atsma
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Elske van den Akker-van Marle
- Department of Biomedical Data Sciences, Section of Medical Decision-Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Willem Jan W Bos
- Department of Internal Medicine, Section of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Wilbert B van den Hout
- Department of Biomedical Data Sciences, Section of Medical Decision-Making, Leiden University Medical Center, Leiden, The Netherlands
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Leao DLL, Pavlova M, Groot WNJ. How to facilitate the introduction of value-based payment models? Int J Health Plann Manage 2024; 39:583-592. [PMID: 38123527 DOI: 10.1002/hpm.3746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/02/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
Value-based payment (VBP) models are designed and implemented to improve outcomes at the same or lower costs. Their adoption requires significant changes in the way healthcare organisations and insurance companies operate. Usually, before VBP models are widely implemented, pilot projects are conducted. Payers need to have a comprehensive set of requirements to enter into agreements with healthcare organisations on these pilots. In this short communication, we outline key elements reported in the literature, inside and outside healthcare organisations, as well as within the contract, that need to be considered in a pilot VBP model. Discussions regarding the introduction of VBP models may be strongly affected by external contextual factors, including regulations, which are outside the control of healthcare organisations. It requires collaboration between organisations, including primary care organisations and hospitals, while within organisations, it frequently requires creating multidisciplinary teams. The focus is on ensuring transparency, collaboration, and shared decision-making, realised by standardising communication processes and regular meetings. Additionally, effective leadership is needed, in which leaders set goals and priorities, as well as manage change. In the contractual agreements between payers and healthcare organisations, outcome measures need to be adequately defined and measured, including individual patient outcomes and composite scores, as well as absolute and relative performance measures. These measures should be tested periodically and catered to the organisations adopting the model. Also, incentives should have adequate size and frequency and be intrinsic and extrinsic. The consideration of these sets of key elements by the payers is essential when implementing VBP model pilot projects.
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Affiliation(s)
- Diogo L L Leao
- Department of Health Services Research, CAHPRI, Maastricht University Medical Center, Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Milena Pavlova
- Department of Health Services Research, CAHPRI, Maastricht University Medical Center, Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Wim N J Groot
- Department of Health Services Research, CAHPRI, Maastricht University Medical Center, Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Cossio-Gil Y, Pérez-Sádaba FJ, Ribera J, Giménez E, Marte L, Ramos R, Aurin E, Peterlunger M, Steinbrink J, Bottinelli EAM, Nelson N, Seveke L, Garin N, Velasco C. Identifying potential predictable indicators for the management of tertiary hospitals. Int J Health Plann Manage 2024; 39:278-292. [PMID: 37910590 DOI: 10.1002/hpm.3710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/28/2023] [Accepted: 09/19/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The European University Hospitals Alliance (EUHA) recognises the need to move from the classical approach of measuring key performance indicators (KPIs) to an anticipative approach based on predictable indicators to take decisions (Key Decision Indicators, KDIs). It might help managers to anticipate poor results before they occur to prevent or correct them early. OBJECTIVE This paper aims to identify potential KDIs and to prioritize those most relevant for high complexity hospitals. METHODS A narrative review was performed to identify KPIs with the potential to become KDIs. Then, two surveys were conducted with EUHA hospital managers (n = 51) to assess potential KDIs according to their relevance for decision-making (Value) and their availability and effort required to be predicted (Feasibility). Potential KDIs are prioritized for testing as predictable indicators and developing in the short term if they were classified as highly Value and Feasible. RESULTS The narrative review identified 45 potential KDIs out of 153 indicators and 11 were prioritized. Of nine EUHA hospitals, 25 members from seven answered, prioritizing KDIs related to the emergency department (ED), hospitalisation and surgical processes (n = 8), infrastructure and resources (n = 2) and health outcomes and quality (n = 1). The highest scores in this group were for those related to ED. The results were homogeneous among the different hospitals. CONCLUSIONS Potential KDIs related to care processes and hospital patient flow was the most prioritized ones to test as being predictable. KDIs represent a new approach to decision-making, whose potential to be predicted could impact the planning and management of hospital resources and, therefore, healthcare quality.
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Affiliation(s)
- Yolima Cossio-Gil
- Department of Evaluation and Information Systems, Vall d'Hebron University Hospital, Barcelona, Spain
- Grup de Recerca en Serveis Sanitaris, Vall d'Hebron University Hospital, Barcelona, Spain
- European University Hospitals Alliance, Barcelona, Spain
| | | | - Jaume Ribera
- Center for Research in Healthcare Innovation Management (CRHIM), IESE Business School, Barcelona, Spain
| | - Emmanuel Giménez
- Department of Evaluation and Information Systems, Vall d'Hebron University Hospital, Barcelona, Spain
- Grup de Recerca en Serveis Sanitaris, Vall d'Hebron University Hospital, Barcelona, Spain
- European University Hospitals Alliance, Barcelona, Spain
| | - Luís Marte
- Department of Evaluation and Information Systems, Vall d'Hebron University Hospital, Barcelona, Spain
- Grup de Recerca en Serveis Sanitaris, Vall d'Hebron University Hospital, Barcelona, Spain
- European University Hospitals Alliance, Barcelona, Spain
| | - Rosa Ramos
- Department of Evaluation and Information Systems, Vall d'Hebron University Hospital, Barcelona, Spain
- Grup de Recerca en Serveis Sanitaris, Vall d'Hebron University Hospital, Barcelona, Spain
- European University Hospitals Alliance, Barcelona, Spain
| | - Eva Aurin
- Department of Evaluation and Information Systems, Vall d'Hebron University Hospital, Barcelona, Spain
- European University Hospitals Alliance, Barcelona, Spain
- Department of Innovation and Digital Health, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Michael Peterlunger
- European University Hospitals Alliance, Barcelona, Spain
- Medical University of Vienna and Vienna General Hospital, Vienna, Austria
| | - Jens Steinbrink
- European University Hospitals Alliance, Barcelona, Spain
- Corporate Strategic Development, Charité - Universitätsmedizin, Berlin, Germany
| | | | - Nina Nelson
- European University Hospitals Alliance, Barcelona, Spain
- Karolinska University Hospital, Stockholm, Sweden
| | - Lynn Seveke
- European University Hospitals Alliance, Barcelona, Spain
| | - Noe Garin
- Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Cesar Velasco
- Health Evaluation and Quality Agency of Catalonia (AQuAS), Barcelona, Spain
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Knufinke-Meyfroyt M, Lancia C, Lodewijks Y, Nienhuijs S, Deckers E. Understanding social dynamics and patient experience in out of hospital care: validation of a co-responsibility questionnaire (CoReCare). Sci Rep 2024; 14:4894. [PMID: 38418491 PMCID: PMC10902371 DOI: 10.1038/s41598-024-54147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/08/2024] [Indexed: 03/01/2024] Open
Abstract
Patient experiences are commonly assessed through patient reported experience measures (PREMs). Ambulatory care models extend traditional care into the patients' home, meaning that a triangle of health care professionals, patients, and their families need to be considered when assessing the remote care experience. These intertwined responsibilities are described by co-responsibility. Currently, PREMs don't reflect how elements to remote care impact this remote care experience. Therefore, this study aimed to develop a questionnaire assessing perceived patient-partner co-responsibility as a PREM in remote care. A 30-item questionnaire was assessed among 1000 individuals aged between 18 and 65 years that tried to lose weight with a partner, friend or family member supporting them. Pairwise item correlations, Exploratory Factor Analysis, and Cronbach's alpha were used for validation. 29-items were identified to reflect co-responsibility across 6 factors: empowerment and support, relational aspects, lack of sympathy, co-participation, accepting help and awareness. Cronbach's alpha ranged between 0.66 and 0.93, showing good internal consistency. We present a validated CoReCare Questionnaire to understand the impact of social dynamics on achieving desired health outcomes in a remote care setting. The CoReCare Questionnaire extends current PREMs when aiming to assess and improve the patient experience of a care episode outside of the hospital.
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Affiliation(s)
| | - Carlo Lancia
- Philips Experience Design, Eindhoven, The Netherlands
| | - Yentl Lodewijks
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Simon Nienhuijs
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Eva Deckers
- Philips Experience Design, Eindhoven, The Netherlands
- Program Management Digitization, Catharina Hospital, Eindhoven, The Netherlands
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Westerink HJ, Steinmann G, Koomans M, van der Kemp MH, van der Nat PB. Value-based healthcare implementation in the Netherlands: a quantitative analysis of multidisciplinary team performance. BMC Health Serv Res 2024; 24:224. [PMID: 38383368 PMCID: PMC10882801 DOI: 10.1186/s12913-024-10712-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/13/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Many hospitals worldwide have set up multidisciplinary Value Improvement (VI) teams that use the Value-Based Health Care (VBHC) theory to improve patient value. However, it remains unclear what the level of VBHC implementation is within these teams. We therefore studied the current level of VBHC implementation in VI teams. METHODS A questionnaire was developed based on the strategic agenda for value transformation and real-world experiences with VBHC implementation. The questionnaire consisted of 21 questions, mapped to seven domains, and was sent out to 25 multidisciplinary VI teams. Median scores for individual questions (scale = 1-5) and average scores per domain were calculated. RESULTS One hundred forty VI team members completed the questionnaire. The overall average score is 3.49. The 'culture and responsibility' domain obtained the highest average score (µ = 4.11). The domain 'measure and improve outcomes' and the domain 'multidisciplinary team' obtained average scores that are slightly higher than the overall average (µ = 3.78 and µ = 3.76 respectively), and the domains 'strategy and organizational policy,' 'collaboration and sharing,' and 'IT and data' scored a little below the overall average (µ = 3.41, µ = 3.32, and µ = 3.29 respectively). The domain 'costs and reimbursement' obtained the lowest average score (µ = 2.42) of all domains, indicating that the implementation of this particular aspect of VBHC remains lagging behind. CONCLUSIONS Our results indicate activity in each of the questionnaire domains. To bring VBHC implementation to the next level, more attention should be given to the financial aspects. Our questionnaire can be used in future studies to identify improvements or differences within VI teams.
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Affiliation(s)
- Henrike J Westerink
- Department of Value Improvement, St. Antonius Hospital, Koekoekslaan 1, 3430EM Nieuwegein, Nieuwegein, 3430 EM, the Netherlands.
- Scientific Center for Quality of Healthcare (IQ Health), Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, 6525 GA, the Netherlands.
| | - Gijs Steinmann
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Maarten Koomans
- Working group 'Integrated Practice Units', Linnean, Zeist, the Netherlands
| | | | - Paul B van der Nat
- Department of Value Improvement, St. Antonius Hospital, Koekoekslaan 1, 3430EM Nieuwegein, Nieuwegein, 3430 EM, the Netherlands
- Scientific Center for Quality of Healthcare (IQ Health), Radboud University Medical Center, Geert Grooteplein Zuid 10, Nijmegen, 6525 GA, the Netherlands
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van Hoorn ES, Ye L, van Leeuwen N, Raat H, Lingsma HF. Value-Based Integrated Care: A Systematic Literature Review. Int J Health Policy Manag 2024; 13:8038. [PMID: 38618830 PMCID: PMC11016279 DOI: 10.34172/ijhpm.2024.8038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 01/30/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Healthcare services worldwide are transforming themselves into value-based organizations. Integrated care is an important aspect of value-based healthcare (VBHC), but practical evidence-based recommendations for the successful implementation of integrated care within a VBHC context are lacking. This systematic review aims to identify how value-based integrated care (VBIC) is defined in literature, and to summarize the literature regarding the effects of VBIC, and the facilitators and barriers for its implementation. METHODS Embase, Medline ALL, Web of Science Core Collection, and Cochrane Central Register of Controlled Trails databases were searched from inception until January 2022. Empirical studies that implemented and evaluated an integrated care intervention within a VBHC context were included. Non-empirical studies were included if they described either a definition of VBIC or facilitators and barriers for its implementation. Theoretical articles and articles without an available full text were excluded. All included articles were analysed qualitatively. The Rainbow Model of Integrated Care (RMIC) was used to analyse the VBIC interventions. The quality of the articles was assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS After screening 1328 titles/abstract and 485 full-text articles, 24 articles were included. No articles were excluded based on quality. One article provided a definition of VBIC. Eleven studies reported-mostly positive- effects of VBIC, on clinical outcomes, patient-reported outcomes, and healthcare utilization. Nineteen studies reported facilitators and barriers for the implementation of VBIC; factors related to reimbursement and information technology (IT) infrastructure were reported most frequently. CONCLUSION The concept of VBIC is not well defined. The effect of VBIC seems promising, but the exact interpretation of effect evaluations is challenged by the precedence of multicomponent interventions, multiple testing and generalizability issues. For successful implementation of VBIC, it is imperative that healthcare organizations consider investing in adequate IT infrastructure and new reimbursement models. Systematic Review Registration: PROSPERO (CRD42021259025).
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Affiliation(s)
- Evelien S. van Hoorn
- Department of Public Health, Erasmus MC, Erasmus University Medical Centre, Rotterdam, The Netherlands
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11
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García-Lorenzo B, Gorostiza A, Alayo I, Castelo Zas S, Cobos Baena P, Gallego Camiña I, Izaguirre Narbaiza B, Mallabiabarrena G, Ustarroz-Aguirre I, Rigabert A, Balzi W, Maltoni R, Massa I, Álvarez López I, Arévalo Lobera S, Esteban M, Fernández Calleja M, Gómez Mediavilla J, Fernández M, del Oro Hitar M, Ortega Torres MDC, Sanz Ferrandez MC, Manso Sánchez L, Serrano Balazote P, Varela Rodríguez C, Campone M, Le Lann S, Vercauter P, Tournoy K, Borges M, Oliveira AS, Soares M, Fullaondo A. European value-based healthcare benchmarking: moving from theory to practice. Eur J Public Health 2024; 34:44-51. [PMID: 37875008 PMCID: PMC10843953 DOI: 10.1093/eurpub/ckad181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with a data-driven approach among healthcare organizations from different health systems. METHODS In the VOICE community-a European healthcare centre cluster intending to address VBHC from theory to practice-information on patient-reported, clinical-related, care-process-related and economic-related outcomes were collected. Patient archetypes were identified using clustering techniques and an indicator set following a modified Delphi was defined. Benchmarking was performed using regression models controlling for patient archetypes and socio-demographic characteristics. RESULTS Six hundred and ninety patients from six healthcare centres were included. A set of 50 health, care-process and economic indicators was distilled for benchmarking. Statistically significant differences across sites have been found in most health outcomes, half of the care-process indicators, and all economic indicators, allowing for identifying the best and worst performers. CONCLUSIONS To the best of our knowledge, this is the first international experience providing evidence to be used with VBHC benchmarking intention. Differences in indicators across healthcare centres should be used to identify best practices and improve healthcare quality following further research. Applied methods might help to move forward with VBHC benchmarking in other medical conditions.
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Affiliation(s)
- Borja García-Lorenzo
- Biosistemak Institute for Health Systems Research, Torre del Bilbao Exhibition Centre, Barakaldo, Spain
| | - Ania Gorostiza
- Biosistemak Institute for Health Systems Research, Torre del Bilbao Exhibition Centre, Barakaldo, Spain
| | - Itxaso Alayo
- Biosistemak Institute for Health Systems Research, Torre del Bilbao Exhibition Centre, Barakaldo, Spain
| | - Susana Castelo Zas
- Osakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation, Innovation and Quality Assistant Service, Barakaldo-Bizkaia, Spain
| | - Patricia Cobos Baena
- Osakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation, Mammary Pathology Service, Barakaldo-Bizkaia, Spain
| | - Inés Gallego Camiña
- Osakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation, Innovation and Quality Assistant Service, Barakaldo-Bizkaia, Spain
| | - Begoña Izaguirre Narbaiza
- Osakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation, Analytical Accounting, Economic and Financial Directorate, Barakaldo, Spain
| | - Gaizka Mallabiabarrena
- Osakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation, Mammary Pathology Service, Barakaldo-Bizkaia, Spain
| | - Iker Ustarroz-Aguirre
- Osakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation, Economic Evaluation Unit, Economic and Financial Directorate, Barakaldo, Spain
| | - Alina Rigabert
- Fundación Andaluza Beturia para la Investigación en Salud (FABIS), Huelva, Spain
| | - William Balzi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Roberta Maltoni
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Ilaria Massa
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Isabel Álvarez López
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Medical Oncology, Donostia, Spain
- Biodonostia, Donostia, Gipuzkoa, Spain
| | - Sara Arévalo Lobera
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Medical Oncology, Donostia, Spain
- Biodonostia, Donostia, Gipuzkoa, Spain
| | - Mónica Esteban
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Economic Resource Service, Donostia, Gipuzkoa, Spain
| | - Marta Fernández Calleja
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Mamary Pathology Service, Donostia, Gipuzkoa, Spain
| | - Jenifer Gómez Mediavilla
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Medical Oncology, Donostia, Spain
| | - Manuela Fernández
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Economic Resource Service, Donostia, Gipuzkoa, Spain
| | - Manuel del Oro Hitar
- Gynecology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - María del Carmen Ortega Torres
- Gynecology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Luís Manso Sánchez
- Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Biomédica del Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pablo Serrano Balazote
- Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Biomédica del Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Carolina Varela Rodríguez
- Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Biomédica del Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Mario Campone
- Institut de Cancérologie de l’Ouest, Angers-Nantes, France
| | - Sophie Le Lann
- Institut de Cancérologie de l’Ouest, Angers-Nantes, France
| | - Piet Vercauter
- Department of Pulmonary Medicine, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Kurt Tournoy
- Department of Pulmonary Medicine, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
- Faculty of Medicine and Life Sciences, Ghent University, Ghent, Belgium
| | | | | | - Marta Soares
- Instituto Português de Oncologia do Porto, Portugal
| | - Ane Fullaondo
- Biosistemak Institute for Health Systems Research, Torre del Bilbao Exhibition Centre, Barakaldo, Spain
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Fernández-Salido M, Alhambra-Borrás T, Casanova G, Garcés-Ferrer J. Value-Based Healthcare Delivery: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:134. [PMID: 38397625 PMCID: PMC10888410 DOI: 10.3390/ijerph21020134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
Healthcare systems are transforming from the traditional volume-based model of healthcare to a value-based model of healthcare. Value generation in healthcare is about emphasising the health outcomes achieved by patients and organisations while maintaining an optimal relationship with costs. This scoping review aimed to identify the key elements and outcomes of implementing value-based healthcare (VBHC). The review process included studies published from 2013 to 2023 in four different databases (SpringerLink, PubMed, ProQuest and Scopus). Of the 2801 articles retrieved from the searches, 12 met the study's inclusion criteria. A total of 11 studies referred to value as the relationship between the outcomes achieved by patients and the costs of achieving those outcomes. Most of the studies highlighted the presence of leadership, the organisation of care into integrated care units, the identification and standardisation of outcome measures that generate value for the patient, and the inclusion of the patient perspective as the most prominent key elements for optimal VBHC implementation. Furthermore, some benefits were identified from VBHC implementation, which could shed light for future implementation actions. Therefore, the VBHC model is a promising approach that may contribute to an improvement in the efficiency and sustainability of healthcare.
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Affiliation(s)
- Mirian Fernández-Salido
- Instituto de Investigación en Políticas de Bienestar Social (POLIBIENESTAR)—Research Institute on Social Welfare Policy, Universitat de València, 46022 Valencia, Spain; (T.A.B.); (J.G.F.)
| | - Tamara Alhambra-Borrás
- Instituto de Investigación en Políticas de Bienestar Social (POLIBIENESTAR)—Research Institute on Social Welfare Policy, Universitat de València, 46022 Valencia, Spain; (T.A.B.); (J.G.F.)
| | - Georgia Casanova
- Centre for Socio-Economic Research on Ageing, IRCCS-INRCA National Institute of Health & Science on Ageing, 60124 Ancona, Italy;
| | - Jorge Garcés-Ferrer
- Instituto de Investigación en Políticas de Bienestar Social (POLIBIENESTAR)—Research Institute on Social Welfare Policy, Universitat de València, 46022 Valencia, Spain; (T.A.B.); (J.G.F.)
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van der Voorden M, Sipma WS, de Jong MFC, Franx A, Ahaus KCTB. The immaturity of patient engagement in value-based healthcare-A systematic review. Front Public Health 2023; 11:1144027. [PMID: 37250089 PMCID: PMC10213745 DOI: 10.3389/fpubh.2023.1144027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/10/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction In recent years, Value-Based Healthcare (VBHC) has been gaining traction, particularly in hospitals. A core VBHC element is patient value, i.e., what matters most to the patient and at what cost can this be delivered. This interpretation of value implies patient engagement in patient-doctor communication. Although patient engagement in direct care in the VBHC setting is well described, patient engagement at the organizational level of improving care has hardly been studied. This systematic review maps current knowledge regarding the intensity and impact of patient engagement in VBHC initiatives. We focus on the organizational level of a continuous patient engagement model. Methods We performed a systematic review following PRISMA guidelines using five electronic databases. The search strategy yielded 1,546 records, of which 21 studies were eligible for inclusion. Search terms were VBHC and patient engagement, or similar keywords, and we included only empirical studies in hospitals or transmural settings at the organizational level. Results We found that consultation, using either questionnaires or interviews by researchers, is the most common method to involve patients in VBHC. Higher levels of patient engagement, such as advisory roles, co-design, or collaborative teams are rare. We found no examples of the highest level of patient engagement such as patients co-leading care improvement committees. Conclusion This study included 21 articles, the majority of which were observational, resulting in a limited quality of evidence. Our review shows that patient engagement at the organizational level in VBHC initiatives still relies on low engagement tools such as questionnaires and interviews. Higher-level engagement tools such as advisory roles and collaborative teams are rarely used. Higher-level engagement offers opportunities to improve healthcare and care pathways through co-design with the people being served. We urge VBHC initiatives to embrace all levels of patient engagement to ensure that patient values find their way to the heart of these initiatives.
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Affiliation(s)
- Michael van der Voorden
- Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Wim S. Sipma
- Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | | | - Arie Franx
- Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Kees C. T. B. Ahaus
- Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
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Darwono B, Tamai K, Côté P, Aleissa S, Rahim AH, Pereira P, Alsobayel H, Chhabra HS, Costanzo G, Ito M, Kandziora F, Lahey D, Menezes CM, Bajammal S, Sullivan WJ, Vajkoczy P, Ahmad A, Arand M, Asmiragani S, Blattert TR, Busari J, Dohring EJ, Misaggi B, Muehlbauer EJ, Mulukutla RD, Munting E, Piccirillo M, Ruosi C, Alturkistany A, Campello M, Hsieh PC, Teli MGA, Wang JC, Nordin M. SPINE20 recommendations 2022: spine care-working together to recover stronger. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:3262-3273. [PMID: 36326928 DOI: 10.1007/s00586-022-07432-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Globally, spine disorders are the leading cause of disability, affecting more than half a billion individuals. However, less than 50% of G20 countries specifically identify spine health within their public policy priorities. Therefore, it is crucial to raise awareness among policy makers of the disabling effect of spine disorders and their impact on the economic welfare of G20 nations. In 2019, SPINE20 was established as the leading advocacy group to bring global attention to spine disorders. METHODS Recommendations were developed through two Delphi methods with international and multi-professional panels. RESULTS In 2022, seven recommendations were delivered to the leaders of G20 countries, urging them to: Develop action plans to provide universal access to evidence-based spine care that incorporates the needs of minorities and vulnerable populations. Invest in the development of sustainable human resource capacity, through multisectoral and inter-professional competency-based education and training to promote evidence-based approaches to spine care, and to build an appropriate healthcare working environment that optimizes the delivery of safe health services. Develop policies using the best available evidence to properly manage spine disorders and to prolong functional healthy life expectancy in the era of an aging population. Create a competent workforce and improve the healthcare infrastructure/facilities including equipment to provide evidence-based inter-professional rehabilitation services to patients with spinal cord injury throughout their continuum of care. Build collaborative and innovative translational research capacity within national, regional, and global healthcare systems for state-of-the-art and cost-effective spine care across the healthcare continuum ensuring equality, diversity, and inclusion of all stakeholders. Develop international consensus statements on patient outcomes and how they can be used to define and develop pathways for value-based care. Recognize that intervening on determinants of health including physical activity, nutrition, physical and psychosocial workplace environment, and smoking-free lifestyle can reduce the burden of spine disabilities and improve the health status and wellness of the population. At the third SPINE20 summit 2022 which took place in Bali, Indonesia, in August 2022, 17 associations endorsed its recommendations. CONCLUSION SPINE20 advocacy efforts focus on developing public policy recommendations to improve the health, welfare, and wellness of all who suffer from spinal pain and disability. We propose that focusing on facilitating access to systems that prioritize value-based care delivered by a competent healthcare workforce will reduce disability and improve the productivity of the G20 nations.
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Affiliation(s)
| | - Koji Tamai
- Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
| | - Pierre Côté
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, ON, Canada
| | - Sami Aleissa
- National Guard Health Affairs, Riyadh, Saudi Arabia
| | | | - Paulo Pereira
- Faculty of Medicine, University of Porto, Porto, Portugal
| | | | | | | | | | - Frank Kandziora
- Center for Spinal Surgery and Neurotraumatology, Frankfurt, Germany
| | - Donna Lahey
- Spine Institute of Arizona, Scottsdale, AZ, USA
| | | | | | | | | | - Alaa Ahmad
- Palestine Polytechnic University, Hebron, Palestine
| | | | | | | | - Jamiu Busari
- Maastricht University, Maastricht, The Netherlands
| | | | | | | | | | | | | | | | | | - Marco Campello
- New York University Grossman School of Medicine, New York, NY, USA
| | - Patrick C Hsieh
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | | | - Jeffrey C Wang
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA
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Schettino G, Capone V. Learning Design Strategies in MOOCs for Physicians' Training: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114247. [PMID: 36361125 PMCID: PMC9657716 DOI: 10.3390/ijerph192114247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 05/28/2023]
Abstract
In recent years, there has been an increased implementation of massive open online courses (MOOCs). This teaching model plays a pivotal role in online education because it can provide high-quality learning resources to numerous students with great feasibility, shaping training courses according to their different learning requirements. Although the widespread adoption of MOOCs in medical education has led to numerous benefits for undergraduate and graduate doctors, their role remains unclear, suggesting the need to analyze the key factors of such a learning method in this field. To achieve this aim, a scoping review, in line with the PRISMA method for qualitative synthesis, was performed by considering studies published from 2016 to 2021, written in English, and including the physician population. Through this literature analysis, the following main areas of interest came to light: (1) pedagogical approaches, (2) MOOC structure-related variables, (3) participant-related variables, and (4) MOOCs vs. traditional courses. The review provides valuable evidence on factors underlying MOOCs effectiveness, which might be helpful for academic and healthcare organizations in designing effective training courses for physicians.
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Corrao G, Franchi M, Mancia G. Knocking on heaven's door: The gap between health institutions and academies in generating knowledge utilizing real-world data. Front Public Health 2022; 10:1002910. [PMID: 36388354 PMCID: PMC9643869 DOI: 10.3389/fpubh.2022.1002910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Giovanni Corrao
- National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Matteo Franchi
- National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- Centro Cardiologico Monzino IRCCS, Milan, Italy
- *Correspondence: Matteo Franchi
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Vijverberg JRG, Daniels K, Steinmann G, Garvelink MM, Rouppe van der Voort MBV, Biesma D, Bos WJW, van Merode F, van der Nat P. Mapping the extent, range and nature of research activity on value-based healthcare in the 15 years following its introduction (2006-2021): a scoping review. BMJ Open 2022; 12:e064983. [PMID: 35973705 PMCID: PMC9386216 DOI: 10.1136/bmjopen-2022-064983] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES We aimed to systematically map the extent, range and nature of research activity on value-based healthcare (VBHC), and to identify research gaps. DESIGN A scoping review with an additional cited reference search was conducted, guided by the Joanna Briggs Institute methodology. DATA SOURCES The search was undertaken in PubMed, Embase and Web of Science. ELIGIBILITY CRITERIA Eligible articles mentioned VBHC or value with reference to the work of Porter or provided a definition of VBHC or value. DATA EXTRACTION AND SYNTHESIS Data were independently extracted using a data extraction form. Two independent reviewers double extracted data from 10% of the articles. Data of the remaining articles (90%) were extracted by one reviewer and checked by a second. The strategic agenda of Porter and Lee was used to categorise the included articles. RESULTS The searches yielded a total of 27,931 articles, of which 1,242 were analysed. Most articles were published in North America. Most articles described an application of VBHC by measuring outcomes and costs (agenda item 2). The other agenda items were far less frequently described or implemented. Most of these articles were conceptual, meaning that nothing was actually changed or implemented. CONCLUSION The number of publications increased steadily after the introduction of VBHC in 2006. Almost one-fifth of the articles could not be categorised in one of the items of the strategic agenda, which may lead to the conclusion that the current strategic agenda could be extended. In addition, a practical roadmap or guideline to implement VBHC is still lacking. Future research could fill this gap by specifically studying the effectiveness of VBHC in day-to-day clinical practice.
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Affiliation(s)
- Joanna R G Vijverberg
- Department of Health Services Research, Maastricht University Medical Centre+, Maastricht, Netherlands
- Department of Value-Based Healthcare, Sint Antonius Hospital, Nieuwegein, Netherlands
| | - Kirsten Daniels
- Department of Value-Based Healthcare, Sint Antonius Hospital, Nieuwegein, Netherlands
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences, Radboudumc, Nijmegen, Netherlands
| | - Gijs Steinmann
- Health Care Governance, Erasmus School of Health Policy and Management, Erasmus Universiteit, Rotterdam, Netherlands
| | - Mirjam M Garvelink
- Department of Value-Based Healthcare, Sint Antonius Hospital, Nieuwegein, Netherlands
| | | | - Douwe Biesma
- Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Willem Jan W Bos
- Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
- Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, Netherlands
| | - Frits van Merode
- Department of Health Services Research, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Paul van der Nat
- Department of Value-Based Healthcare, Sint Antonius Hospital, Nieuwegein, Netherlands
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences, Radboudumc, Nijmegen, Netherlands
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18
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Misplon S, Marneffe W, Himpe U, Hellings J, Demedts I. Evaluation of the implementation of Value-Based Healthcare with a weekly digital follow-up of lung cancer patients in clinical practice. Eur J Cancer Care (Engl) 2022; 31:e13653. [PMID: 35819130 DOI: 10.1111/ecc.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/25/2022] [Accepted: 06/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the implementation of Value-Based Healthcare principles for lung cancer patients in a large Belgian hospital. This hospital implemented a digital platform for the collection of patient-reported outcomes and the standardisation of care pathways. Also, a follow-up by the multidisciplinary care team was put in place. METHODS Evaluation was done by employing a mixed method approach with data analysis of all included patients (n = 201), a pilot study (n = 30) and semi-structured interviews with the care team (n = 5). RESULTS Overall, 95% of all lung cancer patients of two thoracic oncologists agreed to participate in the digital follow-up during the period January 2018 to September 2020 (201 participating patients). The response rates of those patients were high: 92% of the weekly questionnaires and 90% of the 6-weekly ICHOM questionnaires were responded. Based on the pilot study, we conclude that questions are clear and the platform is user-friendly for 90% of patients in the pilot. The interviews revealed that the weekly follow-up has a positive impact on the patient-provider communication and makes it easier to discuss psychological and palliative care needs. CONCLUSION This study shows a successful implementation of Value Based Healthcare with weekly digital follow-up. Clinical trial registration is as follows: www. CLINICALTRIALS gov, NCT04712149.
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Affiliation(s)
| | | | | | - Johan Hellings
- Hasselt University, Hasselt, Belgium.,AZ Delta, Roeselare, Belgium
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