Background The aim of this study was to identify and summarize how value-based healthcare (VBHC) is conceptualized in the literature and implemented in hospitals. Furthermore, an overview was created of the effects of both the implementation of VBHC and the implementation strategies used. Methods A scoping review was conducted by searching online databases for articles published between January 2006 and February 2021. Empirical as well as non-empirical articles were included. Results 1729 publications were screened and 62 were used for data extraction. The majority of the articles did not specify a conceptualization of VBHC, but only conceptualized the goals of VBHC or the concept of value. Most hospitals implemented only one or two components of VBHC, mainly the measurement of outcomes and costs or Integrated Practice Units (IPUs). Few studies examined effects. Implementation strategies were described rarely, and were evaluated even less. Conclusions VBHC has a high level of interpretative variability and a common conceptualization of VBHC is therefore urgently needed. VBHC was proposed as a shift in healthcare management entailing six reinforcing steps, but hospitals have not implemented VBHC as an integrative strategy. VBHC implementation and effectiveness could benefit from the interdisciplinary collaboration between healthcare and management science. Trial registration This scoping review was registered on Open Science Framework https://osf.io/jt4u7/ (OSF | The implementation of Value-Based Healthcare: a Scoping Review).

BackgroundStandardisation of outcome measures is integral to value-based healthcare (VBHC), which may conflict with patient-centred care, focusing on personalisation.ObjectivesWe aimed to provide an overview of measures used to assess the effect of VBHC implementation and to examine to what extent the evidence indicates that VBHC supports patient-centred care.DesignA scoping review guided by the Joanna Briggs Institute methodology.Sources of evidenceWe searched the following databases on 18 February 2021: Cochrane Library, EMBASE, MEDLINE and Web of Science.Eligibility criteriaWe included empirical papers assessing the effect of the implementation of VBHC, published after introduction of VBHC in 2006.Data extraction and synthesisTwo independent reviewers double-screened papers and data were extracted by one reviewer and checked by the other. We classified the study measures used in included papers into six categories: process indicator, cost measure, clinical outcome, patient-reported outcome, patient-reported experience or clinician-reported experience. We then assessed the patient-centredness of the study measures used.ResultsWe included 39 studies using 94 unique study measures. The most frequently used study measures (n=72) were process indicators, cost measures and clinical outcomes, which rarely were patient-centred. The less frequently used (n=20) patient-reported outcome and experience measures often measured a dimension of patient-centred care.ConclusionOur study shows that the evidence on VBHC supporting patient-centred care is limited, exposing a knowledge gap in VBHC research. The most frequently used study measures in VBHC research are not patient-centred. The major focus seems to be on measures of quality of care defined from a provider, institution or payer perspective.

Background: Colorectal cancer is diagnosed in approximately 500,000 patients each year in Europe, leading to a high number of patients having to cope with the consequences of resectable colorectal cancer treatment. As treatment options tend to grow, more information on these treatments’ effects is needed to properly engage in shared decision-making. This study aims to explore the impact of resectable colorectal cancer treatment on patients’ daily life. Methods: Patients (≥18 years) who underwent an oncological colorectal resection between 2018 and 2021 were selected. Purposeful sampling was used to include patients who differ in age, comorbidity, (neo-)adjuvant therapy, postoperative complications and stoma presence. Semi-structured interviews were conducted, guided by a topic guide. Interviews were fully transcribed and subsequently thematically analyzed using the framework approach. Analyses were done by using the predefined themes: 1) daily life and activities, 2) psychological functioning, 3) social functioning, 4) sexual functioning and 5) healthcare experiences. Results: Sixteen patients with a follow-up between 0.6 and 4.4 years after surgery were included in this study. Participants reported several challenges they experience due to poor bowel functioning, stoma presence, chemotherapy-induced neuropathy, fear of recurrence and sexual dysfunction, however, they were reported not to interfere much with daily life. Conclusion: Colorectal cancer treatment leads to several challenges and treatment-related health deficits. This is often not recognized by generic patient-reported outcome measures, but the findings on treatment-related health deficits presented in this study, contain valuable insights which might contribute to improving colorectal cancer care, shared decision making and value based healthcare.

BackgroundColorectal cancer is diagnosed in approximately 500,000 patients each year in Europe, leading to a high number of patients having to cope with the consequences of resection for colorectal cancer. As treatment options tend to grow, more information on the effects of these treatments is needed to engage in shared decision‐making. This study aims to explore the impact of resection for colorectal cancer on patients' daily life.MethodsPatients (≥18 years of age) who underwent an oncological colorectal resection between 2018 and 2021 were selected. Purposeful sampling was used to include patients who differed in age, comorbidity conditions, types of (neo)adjuvant therapy, postoperative complications and the presence/absence of a stoma. Semi‐structured interviews were conducted, guided by a topic guide. Interviews were fully transcribed and subsequently thematically analysed using the framework approach. Analyses were carried out using the following predefined themes: (1) daily life and activities; (2) psychological functioning; (3) social functioning; (4) sexual functioning; and (5) healthcare experiences.ResultsSixteen patients with a follow‐up period of between 0.6 and 4.4 years after surgery were included in this study. Participants reported several challenges experienced because of poor bowel function, a stoma, chemotherapy‐induced neuropathy, fear of recurrence and sexual dysfunction. However, they reported these as not interfering much with daily life.ConclusionColorectal cancer treatment leads to several challenges and treatment‐related health deficits. This is often not recognized by generic patient‐reported outcome measures, but the findings on treatment‐related health deficits presented in this study contain valuable insights which might contribute to improving colorectal cancer care, shared decision making and value‐based health care.