What Do Doctors Think About Value-Based Healthcare? A Survey of Practicing Physicians in a Private Healthcare Provider in Brazil

Makdisse, Márcia; Ramos, Pedro; Malheiro, Daniel Tavares; Felix, Marcelo; Cypriano, Adriana Serra; Soares, Juliana; Carneiro, A. A.; Neto, Miguel Cendoroglo; Klajner, Sidney

doi:10.1016/j.vhri.2019.10.003

Cited by 9 publications

(9 citation statements)

References 9 publications

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“…In the non-empirical literature, the most frequently mentioned component was ‘measuring costs and outcomes for every patient’ ( N = 16)[ 51 – 57 , 59 , 60 , 62 , 65 , 67 , 69 – 72 ]. The second most often mentioned was ‘moving to bundled payments for the full cycle of care’ ( N = 7)[ 51 , 55 , 59 , 61 , 64 , 68 , 69 ]. Six articles described the component ‘organizing care into IPUs’ [ 52 , 55 , 56 , 58 , 66 , 69 ].…”

Section: Resultsmentioning

confidence: 99%

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The implementation of value-based healthcare: a scoping review

Staalduinen

Bekerom

Groeneveld

et al. 2022

BMC Health Serv Res

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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).

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Section: Resultsmentioning

confidence: 99%

“…As to the 22 non-empirical articles, only two fully conceptualized the concept of VBHC [51,52]. In 6 articles, the concept of VBHC was defined solely by reference to its value or its goals: three articles conceptualized only the value in VBHC [53][54][55] and three articles only the goals of VBHC [56][57][58].…”

Section: Vbhc Conceptualizationmentioning

confidence: 99%

The implementation of value-based healthcare: a scoping review

Staalduinen

Bekerom

Groeneveld

et al. 2022

BMC Health Serv Res

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“…We identified three topics related to the healthcare professional, namely (1) personal and professional characteristics, (2) conceptual awareness and understanding, and (3) attitudes toward VBHC. Regarding “personal and professional characteristics” studies investigated, among others, age, job function, and professional values in relation to VBHC awareness ( 46 , 47 ). Other studies showed mixed results regarding gender and job function in relation to VBHC attitudes and scores ( 23 , 48 , 49 ).…”

Section: Resultsmentioning

confidence: 99%

“…Other studies showed mixed results regarding gender and job function in relation to VBHC attitudes and scores ( 23 , 48 , 49 ). Second, scholars investigated professionals' conceptual awareness ( 33 , 46 , 47 , 50 ) and understanding ( 24 , 31 , 33 , 35 , 46 , 49 , 51 – 55 ) of VBHC, which revealed variation and possible prioritization of either patient outcomes or resource consciousness. Last, professionals' attitudes to VBHC were shown to be positive ( 14 , 23 , 24 , 31 , 33 – 35 , 46 , 48 , 53 – 58 ) and/or negative ( 23 , 24 , 31 , 33 – 35 , 38 , 47 , 50 – 53 , 55 , 57 – 59 ).…”

Section: Resultsmentioning

confidence: 99%

“…Second, scholars investigated professionals' conceptual awareness ( 33 , 46 , 47 , 50 ) and understanding ( 24 , 31 , 33 , 35 , 46 , 49 , 51 – 55 ) of VBHC, which revealed variation and possible prioritization of either patient outcomes or resource consciousness. Last, professionals' attitudes to VBHC were shown to be positive ( 14 , 23 , 24 , 31 , 33 – 35 , 46 , 48 , 53 – 58 ) and/or negative ( 23 , 24 , 31 , 33 – 35 , 38 , 47 , 50 – 53 , 55 , 57 – 59 ). Positive attitudes included professionals mentioning that VBHC was received with hope ( 35 ), convincement ( 24 ), excitement and enthusiasm ( 33 ), and with suggested readiness ( 58 ).…”

Section: Resultsmentioning

confidence: 99%

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Value-Based Healthcare From the Perspective of the Healthcare Professional: A Systematic Literature Review

Engen

Bonfrer

Ahaus

et al. 2022

Front. Public Health

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Introduction: Healthcare systems increasingly move toward “value-based healthcare” (VBHC), aiming to further improve quality and performance of care as well as the sustainable use of resources. Evidence about healthcare professionals' contributions to VBHC, experienced job demands and resources as well as employee well-being in VBHC is scattered. This systematic review synthesizes this evidence by exploring how VBHC relates to the healthcare professional, and vice versa.Method: Seven databases were systematically searched for relevant studies. The search yielded 3,782 records, of which 45 were eligible for inclusion based on a two-step screening process using exclusion criteria performed by two authors independently. The quality of the included studies was appraised using the Mixed Methods Appraisal Tool (MMAT). Based on inductive thematic analysis, the Job Demands-Resources (JD-R) model was modified. Subsequently, this modified model was applied deductively for a second round of thematic analysis.Results: Ten behaviors of healthcare professionals to enhance value in care were identified. These behaviors and associated changes in professionals' work content and work environment impacted the experienced job demands and resources and, in turn, employee well-being and job strain. This review revealed 16 constructs as job demand and/or job resource. Examples of these include role strain, workload and meaning in work. Four constructs related to employee well-being, including engagement and job satisfaction, and five constructs related to job strain, including exhaustion and concerns, were identified. A distinction was made between job demands and resources that were a pure characteristic of VBHC, and job demands and resources that resulted from environmental factors such as how care organizations shaped VBHC.Conclusion and Discussion: This review shows that professionals experience substantial job demands and resources resulting from the move toward VBHC and their active role therein. Several job demands are triggered by an unsupportive organizational environment. Hence, increased organizational support may contribute to mitigating or avoiding adverse psychosocial factors and enhance positive psychosocial factors in a VBHC context. Further research to estimate the effects of VBHC on healthcare professionals is warranted.

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