Disentangling the value equation: a step forward in value-based healthcare
Author:
García-Lorenzo Borja1ORCID, Alayo Itxaso1ORCID, Arrospide Arantzazu2ORCID, Gorostiza Ania1ORCID, Fullaondo Ane1ORCID, , Zas Susana Castelo, Baena Patricia Cobos, Camiña Inés Gallego, Narbaiza Begoña Izaguirre, Mallabiabarrena Gaizka, Ustarroz-Aguirre Iker, Rigabert Alina, Balzi William, Maltoni Roberta, Massa Ilaria, López Isabel Álvarez, Lobera Sara Arévalo, Esteban Mónica, Calleja Marta Fernández, Mediavilla Jenifer Gómez, Fernández Manuela, del Oro Hitar Manuel, del Carmen Ortega Torres María, Ferrandez María Consuelo Sanz, Sánchez Luís Manso, Balazote Pablo Serrano, Rodríguez Carolina Varela, Campone Mario, Lann Sophie Le, Vercauter Piet, Tournoy Kurt, Borges Marina, Oliveira Ana Sofía, Soares Marta, Lerma Iratxe Vázquez, Irazabal Izaskun Artola, de Larrinoa Santamaría Aitor Fernandez, Capanaga Andere Frias, Elorduy Eduardo Vicario, Acaiturri-Ayesta Teresa, Gómez-Inhiesto Elisa, Danesi Valentina, Gentili Nicola, Roncadori Andrea, Alarz Fátima Hermoso, Iraola Karmele Imaz, Adam Valerie, De Rijck Helene, Everaert Ellen, Barreira Esmeralda, Medeiros Pedro, Barros Emanuel
Affiliation:
1. Biosistemak Institute for Health Systems Research , Torre del Bilbao Exhibition Centre , Barakaldo, Basque Country, Spain 2. Ministry of Health of the Basque Government , Vitoria-Gasteiz, Spain
Abstract
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.
Funder
Value-Based Healthcare for Outcomes in Breast and Lung Cancer in Europe
Publisher
Oxford University Press (OUP)
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