Northern Territory Department of Health, Casuarina, Australia.
Deeble Institute for Health Policy Research, Canberra, Australia.
Health Promot J Austr. 2023 Jul;34(3):675-680. doi: 10.1002/hpja.736. Epub 2023 May 18.
While value-based health care (VBHC) is transforming Australia's health system, with its focus on patient-centred care and outcomes, it cannot transform Australia's health without policy action to address the social determinants of health. Australia is moving towards a wellbeing economy, but governments have not been explicit in the methods by which the health system will contribute to the development of a wellbeing economy at a macro level. It is also unclear how governments will ensure that approaches to valuing wellbeing will complement current health care innovations in defining and evaluating value in relation to health outcomes. To address this gap, we present a value-based public health (VBPH) framework to conceptualise a health-informed model to expand current thinking about defining, delivering and evaluating the value of population health and wellbeing. The framework provides a critical and innovative approach beyond VBHC for improving population health and wellbeing outcomes, in alignment with principles and measures being put forth in early examples of governments using wellbeing economy policies. In VBPH, the focus is on ensuring value in interventions to improve population outcomes. VBPH offers an approach for joined-up policy across government, using Health in All Policies for multi-sector public health interventions in response to population needs, across full cycles of policy development, implementation and evaluation. It promotes social return on investment methods to measure outcomes that matter to diverse stakeholders within and across communities. VBPH also requires cost estimation from a whole of government perspective, across complete cycles and stages of policy.
虽然基于价值的医疗保健(VBHC)正在改变澳大利亚的医疗体系,注重以患者为中心的护理和结果,但如果没有政策行动来解决健康的社会决定因素,它就无法改变澳大利亚的健康状况。澳大利亚正在向福利经济转型,但政府在卫生系统将如何在宏观层面为福利经济的发展做出贡献方面并没有明确说明方法。也不清楚政府将如何确保评估福利的方法将补充当前医疗保健创新,以确定和评估与健康结果相关的价值。为了解决这一差距,我们提出了一个基于价值的公共卫生(VBPH)框架,以概念化一个健康信息模型,以扩大当前关于定义、提供和评估人口健康和福利价值的思维。该框架为改善人口健康和福利结果提供了一种超越 VBHC 的关键和创新方法,与正在使用福利经济政策的政府早期提出的原则和措施一致。在 VBPH 中,重点是确保改善人口结果的干预措施具有价值。VBPH 提供了一种跨政府的政策协同方法,在全政策周期的发展、实施和评估中,利用健康的所有政策进行多部门公共卫生干预,以满足人口需求。它促进了社会投资回报方法,以衡量社区内外不同利益相关者关心的结果。VBPH 还要求从政府整体角度进行成本估算,涵盖政策的整个周期和阶段。