The implementation of value-based healthcare: a scoping review

Background: The aim of this study was to identify and summarize how value-based healthcare (VBHC) is conceptualized in the literature and implemented in hospitals. Furthermore, an overview was created of the effects of both the implementation of VBHC and the implementation strategies used.Methods: A scoping review was conducted by searching online databases for articles published between January 2006 and February 2021. Empirical as well as non-empirical articles were included.Results: 1729 publications were screened and 62 were used for data extraction. The majority of the articles did not specify a conceptualization of VBHC, but only conceptualized the goals of VBHC or the concept of value. Most hospitals implemented only one or two components of VBHC, mainly the measurement of outcomes and costs or Integrated Practice Units (IPUs). Few studies examined effects. Implementation strategies were described rarely, and were evaluated even less.Conclusions: VBHC has a high level of interpretative variability and a common conceptualization of VBHC is therefore urgently needed. VBHC was proposed as a shift in healthcare management entailing six reinforcing steps, but hospitals have not implemented VBHC as an integrative strategy. VBHC implementation and effectiveness could benefit from the interdisciplinary collaboration between healthcare and management science.The politics and administration of institutional chang

Digital Follow-Up Application for Cancer Patients - Value Mechanisms Regarding Health Professionals' Work

This study examined the value mechanisms of a digital cancer follow-up application (CFUA). Value is defined as the health outcomes achieved per resources used. The focus was on how the digital health intervention (DHI) affects the professionals' work. The research was conducted through interviews of healthcare professionals in the empirical context of gynecological cancer clinic at a university hospital in Finland. The identified key mechanisms were improved coordination and optimized care level. The CFUA improves coordination through reducing time restrictions of work, as the professionals have more chances to time their contacts and plan their work. The CFUA helps in optimizing care level, as the application can effectively filter patients to either nurses or physicians according to symptoms. Coordination mechanism is closely connected to other healthcare value mechanisms, such as reducing waste and supply management. This study increases understanding of DHI value potential recognition, and how value can be actualized.Peer reviewe