Building Blocks of Value Creation Within Value-Based Health Systems: A Delphi Study

Area of Science:

• Health Services Research
• Health Technology Assessment
• Health Economics

Background:

• Identifying factors that drive value in health technologies is crucial for effective resource allocation.
• Existing frameworks may not fully capture the complexities of value creation in healthcare systems.
• A structured approach is needed to incorporate diverse stakeholder perspectives and system-level factors.

Purpose of the Study:

• To develop a consensus-driven framework defining key factors influencing value creation in health technologies.
• To identify system-level barriers that may impede the impact of health technologies.
• To provide an evidence-based, system-centered approach for health technology value assessment.

Main Methods:

• A mixed-method approach combining a targeted literature review and a 3-round web-based Delphi exercise with 22 experts.
• Initial framework draft informed by 21 existing frameworks.
• Thematic analysis of expert-contributed value statements followed by Likert scale ratings for consensus building.

Main Results:

• A scoping review identified 10 value domains and 46 subdomains.
• The Delphi exercise generated 61 value statements across 38 subdomains.
• 17 value statements achieved consensus and stability, forming the basis of the final framework.

Conclusions:

• The developed value framework provides an evidence-based, system-centered approach to health technology value assessment.
• The framework integrates diverse stakeholder perspectives and crucial system factors, addressing gaps in current value capture.
• Further research is recommended to validate the identified domains and subdomains across various healthcare settings.