A Framework for Implementing Value-Based Healthcare in China

Article type
Authors
Bai A1, Jiang Y2, Gray M3
1School of Population Medicine and Public Health, Chinese Academy Of Medical Science & Peking Union Medical College, Beijing, China; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, The United Kingdom
2School of Population Medicine and Public Health, Chinese Academy Of Medical Science & Peking Union Medical College, Beijing, China; School of Health Policy and Management, Chinese Academy Of Medical Science & Peking Union Medical College, Beijing, China
3Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, The United Kingdom
Abstract
Background
In the 21st century, a paradigm shift towards value-based healthcare, prioritizing patient-centered outcomes relative to costs, necessitates a fundamental restructuring of current healthcare systems [1]. While ongoing efforts target safety and waste reduction, the organizational fragmentation of medical services hinders progress in enhancing population health outcomes.
Objectives
This study endeavors to establish a comprehensive value-based healthcare system in Gejiu city, Yunnan province, China, aligning interventions with evidence-based practices to maximize both population and personalized benefits.
Methods
Drawing on the taxonomy developed by the European Union Expert Panel, the study identifies and improves four dimensions of value: personal, technical, allocative, and social value [2]. The development agenda comprises five key components: identifying common needs within population sub-groups and optimizing resource allocation; designing tailored systems for specific sub-groups, such as patients with chronic airway disease (CAD); encouraging shared decision-making to optimize personal value; ensuring equitable value delivery through aligned networks; and fostering a stewardship culture with a governance process promoting collective responsibility [3].The implementation of system involves setting measurable objectives and criteria to assess performance [4-5].
Results
The system aims to reduce CAD incidence, prevalence and mortality, improve CAD patients’ quality of life, and prolong their lives. Enhancing personalized value focuses on early detection, effective treatment, and mitigating financial burdens, with objectives including improving health promotion and CAD prevention effectiveness, enhancing CAD diagnosis accuracy, and improving treatment and rehabilitation effectiveness and personalization. Allocative value is addressed through equitable resource distribution, waste reduction, and minimizing unwarranted variation. Objectives encompass ensuring integrated care for multiple morbidities and facilitating psychological adaptation among CAD patients. Technical value is enhanced by optimizing outcomes with available resources, promoting a reduced carbon footprint, supporting research, and ensuring effective training for relevant professional staff. Achieving social value involves producing an annual report for this system, connected with evaluating medical services quality and the benefits of medical staff.
Conclusions
Implementing a value-based healthcare system in Gejiu city ensures judicious resource allocation based on evidence, emphasizing the patient experience and reconciling individual requirements with resource constraints. This framework fosters a transformative shift towards value-centric healthcare practices in the Chinese healthcare landscape.