Disentangling the value equation: a step forward in value-based healthcare

Area of Science:

• Health Economics
• Patient-Reported Outcomes Research
• Value-Based Healthcare Metrics

Background:

• The value equation in value-based healthcare (VBHC) lacks a standardized single figure due to challenges in aggregating patient-centered outcomes (PCOs).
• Current VBHC frameworks are often theoretical, hindering practical decision-making and benchmarking.

Purpose of the Study:

• To estimate the weights of various PCOs to create a single numerator value for the VBHC equation.
• To advance the practical application of VBHC by developing a quantifiable value metric.

Main Methods:

• A cohort of 690 breast cancer patients across six European hospitals (2019-20) with 6-month follow-up was analyzed.
• Patient-reported outcomes (PROs), clinical-related outcomes (CROs), and clinical/demographic data were collected.
• Regression analysis was used to determine weights for PCOs, forming a composite indicator (CI-PCO).

Main Results:

• Pain, physical functioning, emotional functioning, and ability to work received the highest weights in the CI-PCO.
• The derived PCO weights were robust under sensitivity analysis.
• The composite indicator of PCOs (CI-PCO) proved more informative than health-related quality of life (HRQoL).

Conclusions:

• This research presents the first method to combine ICHOM-proposed PCOs into a single numerator figure for VBHC.
• The developed metric facilitates holistic benchmarking and value-based payment models across healthcare centers.
• The methodology offers a pathway for application in other medical conditions to enhance VBHC implementation.