de Mattia Egidio, Angioletti Carmen, D'Agostino Melissa, Paoletti Filippo, de Belvis Antonio Giulio
Faculty of Economics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Critical Pathways and Evaluation Outcome Unit, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS, 00168 Rome, Italy.
Healthcare (Basel). 2024 Dec 5;12(23):2457. doi: 10.3390/healthcare12232457.
BACKGROUND/OBJECTIVES: The principles of value-based healthcare (VBHC) have received widespread endorsement, leading healthcare organizations worldwide to shift their strategies towards them. However, despite growing recognition and acceptance, the actual implementation of value-based approaches varies widely. This research aims to identify studies that address the implementation of VBHC at different levels (healthcare policymakers, hospital administrators, and healthcare providers), focusing on each level's relative strategies.
To this end, a scoping review was conducted in accordance with the PRISMA extension for the scoping reviews checklist. The electronic databases of Web of Science, PubMed, MEDLINE, and Scopus were searched to identify relevant publications in English from January 2006 to 31 July 2023.
We identified 30 eligible studies. Findings are organized into four main macro strategic levels, each comprising specific dimensions and operational approaches. Fourteen articles analyzed the role of government commitment in VBHC implementation, while six articles focused on regional integrated care systems. The role of hospitals was described in sixteen records.
Our study suggests that a comprehensive approach is necessary for the successful implementation of VBHC. Hospitals emerge as pivotal in this shift, requiring organizational and attitudinal changes among healthcare professionals. However, a complete transition towards VBHC that ensures seamless patient management throughout the entire care delivery value chain necessitates government involvement in terms of state legislation, reimbursement methods, and hospital networking.
背景/目标:基于价值的医疗保健(VBHC)原则已得到广泛认可,促使全球医疗保健组织将其战略转向该方向。然而,尽管认可度和接受度不断提高,但基于价值的方法的实际实施情况却差异很大。本研究旨在确定针对不同层面(医疗保健政策制定者、医院管理人员和医疗保健提供者)实施VBHC的研究,重点关注每个层面的相关战略。
为此,根据PRISMA扩展的范围审查清单进行了范围审查。检索了科学网、PubMed、MEDLINE和Scopus的电子数据库,以识别2006年1月至2023年7月31日期间的英文相关出版物。
我们确定了30项符合条件的研究。研究结果分为四个主要的宏观战略层面,每个层面包括特定的维度和操作方法。14篇文章分析了政府承诺在VBHC实施中的作用,6篇文章关注区域综合护理系统。16条记录描述了医院的作用。
我们的研究表明,成功实施VBHC需要采取综合方法。医院在这一转变中起着关键作用,需要医疗保健专业人员在组织和态度上做出改变。然而,要实现向VBHC的完全转变,确保在整个护理交付价值链中实现无缝的患者管理,政府需要在国家立法、报销方法和医院联网方面参与进来。