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Review article
peer-reviewed

Defining Health in the Era of Value-based Care: Lessons from England of Relevance to Other Health Systems



Abstract

The demand for healthcare is rising due to aging populations, rising chronic disease prevalence, and technological innovations. There are currently more effective and cost-effective interventions available than can be afforded within limited budgets. A new way of thinking about the optimal use of resources is needed. Ensuring that available resources are used for interventions that provide outcomes that patient’s most value, rather than a focus just on effectiveness and cost-effectiveness, may help to ensure that resources are used optimally. Value-based healthcare puts what patients value at the center of healthcare. It helps ensure that they receive the care that can provide them with outcomes they think are important and that limited resources are focused on high-value interventions. In order to do this, we need flexible definitions of ‘health’, personalized and tailored to patient values.

We review the current status of value-based health care in England and identify lessons applicable to a variety of health systems. For this, we draw upon the work of the National Institute for Health and Care Excellence (NICE), the National Health Service (NHS), Right Care Initiative, and our local experience in promoting value-based health care for specific conditions in our region. Combining the best available evidence with open and honest dialogue between patients, clinicians, and others, whilst requiring considerable time and resources are essential to building a consensus around the value that allows the best use of limited budgets.

Values have been present in healthcare since its beginnings. Placing value and values at the center of healthcare could help to ensure available resources are used to provide the greatest possible benefit to patients.



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Review article
peer-reviewed

Defining Health in the Era of Value-based Care: Lessons from England of Relevance to Other Health Systems


Author Information

Sarah Gentry Corresponding Author

Directorate of Public Health and Protection, Suffolk County Council

Public Health and Primary Care, University of East Anglia

Padmanabhan Badrinath

Directorate of Public Health and Protection, Suffolk County Council

Department of Public Health and Primary Care, University of Cambridge


Ethics Statement and Conflict of Interest Disclosures

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Acknowledgements

The opinions expressed in this review article are the authors' own and do not reflect the view of the Suffolk County Council, University of Cambridge, or the University of East Anglia.


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Review article
peer-reviewed

Defining Health in the Era of Value-based Care: Lessons from England of Relevance to Other Health Systems

Sarah Gentry">Sarah Gentry , Padmanabhan Badrinath">Padmanabhan Badrinath

  • Author Information
    Sarah Gentry Corresponding Author

    Directorate of Public Health and Protection, Suffolk County Council

    Public Health and Primary Care, University of East Anglia

    Padmanabhan Badrinath

    Directorate of Public Health and Protection, Suffolk County Council

    Department of Public Health and Primary Care, University of Cambridge


    Ethics Statement and Conflict of Interest Disclosures

    Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements

    The opinions expressed in this review article are the authors' own and do not reflect the view of the Suffolk County Council, University of Cambridge, or the University of East Anglia.


    Article Information

    Published: March 06, 2017

    DOI

    10.7759/cureus.1079

    Cite this article as:

    Gentry S, Badrinath P (March 06, 2017) Defining Health in the Era of Value-based Care: Lessons from England of Relevance to Other Health Systems. Cureus 9(3): e1079. doi:10.7759/cureus.1079

    Publication history

    Received by Cureus: January 22, 2017
    Peer review began: February 07, 2017
    Peer review concluded: February 21, 2017
    Published: March 06, 2017

    Copyright

    © Copyright 2017
    Gentry et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The demand for healthcare is rising due to aging populations, rising chronic disease prevalence, and technological innovations. There are currently more effective and cost-effective interventions available than can be afforded within limited budgets. A new way of thinking about the optimal use of resources is needed. Ensuring that available resources are used for interventions that provide outcomes that patient’s most value, rather than a focus just on effectiveness and cost-effectiveness, may help to ensure that resources are used optimally. Value-based healthcare puts what patients value at the center of healthcare. It helps ensure that they receive the care that can provide them with outcomes they think are important and that limited resources are focused on high-value interventions. In order to do this, we need flexible definitions of ‘health’, personalized and tailored to patient values.

We review the current status of value-based health care in England and identify lessons applicable to a variety of health systems. For this, we draw upon the work of the National Institute for Health and Care Excellence (NICE), the National Health Service (NHS), Right Care Initiative, and our local experience in promoting value-based health care for specific conditions in our region. Combining the best available evidence with open and honest dialogue between patients, clinicians, and others, whilst requiring considerable time and resources are essential to building a consensus around the value that allows the best use of limited budgets.

Values have been present in healthcare since its beginnings. Placing value and values at the center of healthcare could help to ensure available resources are used to provide the greatest possible benefit to patients.



Want to read more?

Create a free account to continue reading this article.

Already a member? Login.



Sarah Gentry

Directorate of Public Health and Protection, Suffolk County Council

For correspondence:
sarah.gentry@doctors.org.uk

Padmanabhan Badrinath

Directorate of Public Health and Protection, Suffolk County Council

Sarah Gentry

Directorate of Public Health and Protection, Suffolk County Council

For correspondence:
sarah.gentry@doctors.org.uk

Padmanabhan Badrinath

Directorate of Public Health and Protection, Suffolk County Council