Hospital Methodology for Steering on Patient Value: Healthcare Outcomes in Relation to Costs

OBJECTIVES: Health Technology Assessment methods are widely used to assess the cost-effectiveness of care services at the macro level. However, at the meso (organizational) level we need such methods as well, to differentiate efficient from inefficient care. Within care organizations, managers prioritize costs, while medical specialists focus on patient-relevant outcomes. Value-Based Healthcare (VBHC) has the promise to bridge this gap. This research aims to develop a sustainable methodology for managing outcomes in relation to costs, ensuring more patient-centered and efficient healthcare at the organizational level.

METHODS: This research is conducted in the Santeon hospital group: at the rheumatology department of the Maasstad hospital and the IBD department of the Catharina hospital. First, individual interviews are conducted with relevant stakeholders (CEO, executive staff, medical manager, clinic team manager, healthcare manager, nurse, finance professional, and a patient) using a structured interview guide. Next, focus groups are held to reach consensus on one methodology. Two independent researchers analyze the data including a member check.

RESULTS: Based on our preliminary findings, our advice is to use a management dashboard to visualize patient-relevant outcomes relative to their cost. This dashboard should be discussed during quarterly meetings with care and business operation managers. A multidisciplinary improvement team is crucial to support its implementation. Investments should be made into enhanced collaboration and education among staff. Building on existing initiatives such as ICHOM1 and the FAIR principles2 is recommended Additionally, health insurers need to be aligned with potential changes within care pathways to ensure financial support and incentives.

CONCLUSIONS: Our preliminary findings support the need and feasibility to develop a methodology to steer on patient-relevant outcomes relative to their costs. Further research is necessary to validate this methodology before evaluating its impact.