Opieka medyczna
What is value in medicine? Value-based healthcare model and its implementation in medical practice
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“You have to put the patient first. - this phrase is heard by almost every medical student or doctor in the process of preparing for the profession. However, in the current health care system, where patient care is fragmented and specialists are accounted for based on the number of visits made and services provided, this is not the simplest task.
With the increased need for humanization of treatment and a holistic approach to the patient, a new concept has materialized. Value-based healthcare (VBHC), that is, value-based medicine, is a model of organization of the health care system whose goal is achieving results that have a significant impact on the patient's quality of life and in accordance with his needs. In turn, doctors are to be compensated based on the implementation of this assumption.
In this article, you will learn how value is defined in medicine according to the VBHC model and how to take the first steps towards implementing such a model in your medical practice.
When describing the value-based healthcare model, it is important to consider the definition of the word “value”, which was included in their publication “Redefining Health Care” by the creators of the concept, Michael Porter and Elisabeth Teisberg:
Value in healthcare is equal to the outcomes that matter to patients, relative to the cost of delivering them.
The authors of the European VBHC guidelines have extended this definition to include pillars that provide guidance for its implementation in practice:
The pursuit of these objectives should lead to development of a health care system in which financial and time losses are minimized, and a place is created for building a fruitful doctor-patient relationship in the therapeutic process. In this article, you will learn what value-oriented care is and how you can implement it in your medical practice.
Diabeter is a group of Dutch clinics dedicated to the care of patients suffering from type 1 diabetes. By focusing resources on the treatment of one specific condition, experts have created the conditions for multidisciplinary cooperation of specialists and holistic patient care. In addition, in keeping with the spirit of VBHC, Diabeter meticulously collects ProMS (Patient-Reported Outcomes) and controls objective treatment outcomes (HbA1c%). For this purpose, it uses a special online platform, used to contact patients and record measurements from glucometers and insulin pumps. The information received allows us to evaluate, which staff activities bring the most benefit to patientsand that only generate unnecessary costs.
Important for the implementation of the project was the methodology of data collection. Diabeter adheres to international ICHOM standards, which facilitate the evaluation of the effects of treatment of patients with diabetes. it systematization of collected data enabled a more reliable evaluation of the results achieved and the possibility of comparing them on a larger scale, including on an international scale.
The success of the project is evidenced by the results of the patients of the clinic - they maintain healthier glycaemic levels than the general population of the Netherlands with type 1 diabetes (55% vs 28% with HbAC1< 7.5%), and Less likely to require hospitalization (3% vs 8%). As summarized by Dr. Henk Veeze, one of the founders: “Currently, 10% of Dutch hospitals have referred their diabetes patients to the Diabeter group, including two of the seven university hospitals.2”
Importantly, the Diabeter group managed to achieve these results without raising costs incurred as part of benefits.
The medical literature describes numerous examples of the introduction of the value-based healthcare model in healthcare around the world. The first steps you can take to also adhere to the VBHC assumptions include:
EIT Health also made available VBHC implementation scheme, which can be helpful in planning changes to your medical practice.
Value-based healthcare is the model of the health care system that, according to WHO, the world should strive for in the 21st century. It is based on putting the patient at the center of the therapeutic process, but it also has numerous benefits for doctors and other healthcare professionals. In addition, it allows to reduce the cost of treatment in relation to the health results obtained. EIT Health created guide, from which you can learn more about the implementation of VBHC in your practice and how it is already being implemented in Europe.
