He Wenbo, Feng Wei, Du Liang, Zhang Wei
Innovation Institute for Integration of Medicine and Engineering, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
School of Public Health, Sichuan University, Chengdu, China.
J Clin Nurs. 2025 Feb;34(2):454-463. doi: 10.1111/jocn.17597. Epub 2024 Dec 4.
To identify the principal factors influencing the implementation of high-value healthcare performance evaluation and to examine the interrelationships among these factors.
Value-based health care (VBHC) is gaining momentum as a model that focuses on improving patient outcomes. However, there is still a lack of understanding of the multifaceted factors that contribute to its successful implementation.
Theoretical modelling and mixed research methods.
First, this study constructed a framework of influencing factors on the implementation of VBHC performance evaluation based on the Technology-Organization-Environment model. Second, a representative set of influencing factors for healthcare performance evaluation was identified. The implementation of performance evaluation was identified based on a literature analysis and a case study in China. Finally, experts were invited to assess the relevance of the aforementioned influencing factors, and the collected data were analysed using Interpretative Structural Model. The PRISMA-ScR checklist guided the reporting of this study.
We initially constructed the theory framework with the objective of categorising and summarising the influential factors and potential problems revealed in the implementation of patient VBHC performance evaluation in general hospitals. Subsequently, 15 key factors were identified through interviews with 10 experts. Then, a six-level hierarchy was developed to construct a visual structure diagram, the purpose of which was to clarify the hierarchy of roles of each influencing factor. Finally, we categorise the influencing factors into four clusters based on their driving power and dependency within the system.
The insights from this research will assist hospital managers in identifying and prioritising the key factors that influence high-value healthcare performance.
This study provides a reliable pathway reference for clinical and nursing performance value enhancement and provides important insights into resource allocation and decision-making for clinical practitioners.
No patient or public contribution.
确定影响高价值医疗绩效评估实施的主要因素，并考察这些因素之间的相互关系。
基于价值的医疗保健（VBHC）作为一种专注于改善患者结局的模式正日益兴起。然而，对于促成其成功实施的多方面因素仍缺乏了解。
理论建模和混合研究方法。
首先，本研究基于技术-组织-环境模型构建了VBHC绩效评估实施的影响因素框架。其次，确定了一套具有代表性的医疗绩效评估影响因素。通过文献分析和中国的一个案例研究确定了绩效评估的实施情况。最后，邀请专家评估上述影响因素的相关性，并使用解释性结构模型对收集到的数据进行分析。PRISMA-ScR清单指导了本研究的报告撰写。
我们最初构建理论框架的目的是对综合医院患者VBHC绩效评估实施中揭示的影响因素和潜在问题进行分类和总结。随后，通过与10位专家的访谈确定了15个关键因素。然后，建立了一个六级层次结构以构建可视化结构图，其目的是阐明每个影响因素的作用层次。最后，我们根据影响因素在系统中的驱动力和依赖性将其分为四个集群。
本研究的见解将帮助医院管理者识别影响高价值医疗绩效的关键因素并确定其优先级。
本研究为临床和护理绩效价值提升提供了可靠的途径参考，并为临床从业者的资源分配和决策提供了重要见解。
无患者或公众贡献。
