Patient-Level Value Analysis: An Innovative Approach to Optimize Care Delivery

Area of Science:

• Orthopaedic surgery
• Health economics
• Value-based care

Background:

• Rising healthcare costs necessitate value-based care systems in orthopaedics.
• Patient-level value analysis offers a novel approach to quantify and optimize care value.
• Traditional methods primarily measure, rather than improve, healthcare value.

Purpose of the Study:

• To develop a patient-level value analysis model for orthopaedic care.
• To assess the efficacy of this model in improving orthopaedic care value.

Main Methods:

• Prospective study of patients with isolated closed ankle fractures.
• Collected functional outcome scores and used time-driven activity-based costing for cost analysis.
• Defined value as change in outcome score divided by cost; employed multiple linear regression.

Main Results:

• Multiple linear regression identified physician treatment and inpatient stay as predictors of lower value.
• Specific findings: Physician D (β = -0.135, P = 0.04) and inpatient stay (β = -0.468, P < 0.01).
• Identified key areas for potential care pathway and value improvement.

Conclusions:

• Patient-level value analysis signifies a paradigm shift in quantifying healthcare value.
• Recommends adoption of systems to quantify and optimize care value by surgeons and health systems.
• Highlights the potential for significant improvements in orthopaedic care delivery.