Value-based (in the context of healthcare)
Value-Based Health Care is “a framework for restructuring health care systems around the globe with the overarching goal of value for patients”
(Source: Professor Michael Porter)
Values and value can be interpreted and defined in many different ways depending on context and perspectives. In healthcare, value-based tends to adopt a patient perspective, focusing on outcomes that matter to patients, relative to the total cost for achieving those outcomes.
The European Commission Expert Panel on effective ways of investing in health (EXPH) proposes to define “value-based healthcare (VBHC)” as a comprehensive concept built on four value-pillars: appropriate care to achieve patients’ personal goals (personal value), achievement of best possible outcomes with available resources (technical value), equitable resource distribution across all patient groups (allocative value) and contribution of healthcare to social participation and connectedness (societal value).
The European Alliance for Value in Health believes value-based, sustainable, and people-centred health systems are built around six key principles found here.
Sustainability is fundamental to quality services and systems and encompasses the enhancement of resilience to financial, environmental, health and other unforeseen circumstances.
Full-continuum of care
The degree to which a series of discrete health care events is experienced by people as coherent and interconnected over time and consistent with their health needs and preferences (Source: WHO).
An approach to care that consciously adopts the perspectives of individuals, carers, families and communities as participants in and beneficiaries of trusted health systems that are organized around the comprehensive needs of people rather than individual diseases, and that respect social preferences. People-centred care is broader than patient and person-centred care, encompassing not only clinical encounters, but also including attention to the health of people in their communities and their crucial role in shaping health policy and health services. Person-centred care: care approaches and practices in which the person is seen as a whole, with many levels of needs and goals, the needs being derived from their personal social determinants of health. (Source: WHO)
Best practices refer to recommendations and guidelines, and documented cases of good and interesting practices or case studies that have been developed and implemented to assist in either healthcare and clinical decisions, or healthcare system transformation, that intend to optimise patient care and outcomes. Best practices are informed by evidence and assessment of benefits and harms.
A stakeholder is anyone (legal or physical entity( that can have an impact on health outcomes. Stakeholders include all those active in broader health systems including, for example, policy makers, payers, industry, health professionals, healthcare providers, citizens, patients, carers and other beneficiaries at European, national and regional levels.
Outcomes in health are measurable components or endpoints observed following an intervention (or absence of intervention) which are relevant for an individual and are generally collected through validated instruments. For example outcomes may encompass health status or recovery status (such as pain levels or quality of life). Outcomes can be both clinical (e.g. measured by a diagnostic tool or other examination) or patient-reported (usually collected through validated surveys to patients).
Care delivery encompasses the care and services from all professionals involved in health care from diagnosis to rehabilitation and home care.
Financing models refers to ways in which healthcare services are funded, paid for, or reimbursed. For example pay-for-value or pay-for-performance models encourage healthcare providers to deliver the best quality care (i.e. rewarding value and outcomes), as opposed to pay-for-volume models in which healthcare providers are paid for each service performed.
Prevention includes not only the primary prevention of disease (actions aimed at avoiding the manifestation of disease e.g. vaccination and appropriate nutrition), but also secondary prevention of onset or worsening of a disease or condition through early screening and detection (e.g. regular blood pressure monitoring), and tertiary prevention whereby one manages their disease or condition as best as possible to slow or stop progression and to reduce the effects of the disease once established in an individual.
A health ecosystem not only embodies general health system actors including primary care services (General Practitioners and community services etc.) and secondary care services (hospitals etc.), but all professions associated with healthcare, including management and the manufacturing, purchase and delivery of goods and services, digital enablers, laws and other infrastructures.