Redesigning value-based hospital structures: a qualitative study on value-based health care in the Netherlands

Area of Science:

• Health Services Research
• Organizational Studies
• Healthcare Management

Background:

• Value-based health care necessitates organizational restructuring for efficient patient care delivery.
• Current practical implementation of value-based hospital structures remains unclear.
• This study investigates how Dutch hospitals approach value-based redesign.

Purpose of the Study:

• To explore the implementation and pursuit of value-based redesign in Dutch hospitals.
• To understand the practical strategies employed by hospitals in reorganizing for value creation.
• To identify challenges and facilitators in transitioning to value-based organizational structures.

Main Methods:

• Qualitative exploratory study utilizing semi-structured interviews and a focus group.
• Deductive coding of transcripts based on Mintzberg's theory of organizational design parameters.
• Analysis of organizational strategies for value-based health care implementation.

Main Results:

• Dutch hospitals frequently use liaison devices (e.g., project teams, committees) for value-based restructuring.
• Formation of units around specific medical conditions is less common.
• Outcome data are widely used; external benchmarking is practiced by some, but cost indicators are not universally employed.

Conclusions:

• Value-based redesign is an incremental process, not requiring radical or binary changes.
• Hospitals have diverse options for implementing value-based structures.
• A conceptualization of "value-based design parameters" can guide strategies for improved care cycle coordination.