Elements of Value-Based Health Care and Recommendations for Developing a Theoretical Framework: A Scoping Review

Reyhaneh  Sharifi; Shaghayegh  Vahdat; Shahram  Tofighi; Somayeh  Hessam

doi:10.18502/mshsj.v10i4.21555

Reyhaneh Sharifi Ph.D. student of Health Services Management, Department of Health Services Management, ST.C., Islamic Azad University, Tehran, Iran
Shaghayegh Vahdat Associate Professor, Department of Health Services Management, ST.C., Islamic Azad University, Tehran, Iran
Shahram Tofighi Associate Professor, Department of Foresight, Theorizing and Macro-Health Monitoring, Academy of Medical Sciences of Islamic Republic of Iran, Tehran, Iran
Somayeh Hessam Associate Professor, Department of Health Services Management, ST.C., Islamic Azad University, Tehran, Iran

DOI: https://doi.org/10.18502/mshsj.v10i4.21555

Keywords: Value-Based Health Care (VBHC), Patient-centered care, Quality of health care

Abstract

Objective: Value-Based Health Care (VBHC) is an innovative approach to improving the delivery of health services, designed to maximize value for patients. Despite its development in several countries, a shared and comprehensive understanding of the concept has yet to emerge. Accordingly, this study was conducted to identify the key elements of Value-based healthcare and to examine how these elements are implemented in hospitals and health systems across different countries.

Information sources and selected methods for study: The study was conducted following Arksey and O’Malley’s six-stage framework for scoping reviews and in accordance with the PRISMA-ScR guidelines. A systematic search of ten databases and two websites was performed in English and Persian for the period 2006 to 2024 and was supplemented by a manual search. Reference management and study screening were carried out using Endnote 2020, resulting in the selection of 70 studies. These studies were subsequently coded in MaxQDA 2020, and the relevant elements were identified and categorized using Braun and Clarke’s six-phase thematic analysis approach.

Results: During the thematic analysis phase, 117 codes were identified and organized into 15 elements within eight groups, including defining value in the healthcare delivery system; delivering patient-centered, integrated, comprehensive, and coordinated care; measuring outcomes and costs; integrating care delivery systems; expanding the geographic scope of care; reforming service reimbursement systems; establishing an active health information technology platform; and conducting comprehensive evaluations to improve value. In most countries, greater emphasis had been placed on measuring outcomes and costs and on organizing integrated practice units compared with the other identified elements.

Conclusion: Not all of the six elements proposed by Porter and Tizberg have been implemented uniformly in different countries, and attention to other key elements is needed for a more comprehensive conceptualization of Value-Based Health Care. Also, the elements recommended based on the findings of this study in the following three groups can be helpful in developing a theoretical framework for value-based healthcar: defining the concept and determining how to measure value; providing patient-centered, integrated, comprehensive, and coordinated care; and comprehensive evaluation and improvement of value.