Abstract
Value-Based Healthcare (VBHC) focuses on optimizing patient value by reshaping how care is delivered, organized, measured, and reimbursed.
Hospitals and healthcare professionals are crucial to implementing VBHC. This dissertation addresses three knowledge gaps hindering its progress:
Gap 1: insufficient guidance for hospitals implementing VBHC
Through mixed-methods research, we examine the decade-long (2012–2023) change towards VBHC at Erasmus Medical Center, a pioneering Dutch university hospital. This research investigates: (1) The evolution of the hospital's VBHC implementation strategy over the decade and its outcomes, analyzed through a complexity-lens; (2) Patient response rates to Patient Reported Outcome Measures (PROMs) and healthcare professionals' use of this data; (3) Strategies to improve PROMs use by patients and clinicians, including identifying patient and consultation characteristics associated with response behavior.
Gap 2: lack of clarity and consensus on VBHC in daily practice
In our Delphi study, clinicians identified 63 key activities essential for VBHC, emphasizing person-centered care, care optimization, and resource stewardship.
Gap 3: limited attention to healthcare professionals within VBHC
Through a systematic literature review and interview study, we examine the experiences of healthcare professionals in various (inter)national hospitals with VBHC, applying the Job Demands-Resources model. We find both positive and negative perceived impacts on their motivation, workload, and engagement, and describe the mechanisms behind these ‘gains’ and ‘pains.’
Key contributions of this thesis include framing VBHC as a goal-means hierarchy, applying insights from complexity theory to navigate the value movement, and emphasizing the importance of prioritizing the motivation, well-being and (re)professionalization of healthcare professionals.
Hospitals and healthcare professionals are crucial to implementing VBHC. This dissertation addresses three knowledge gaps hindering its progress:
Gap 1: insufficient guidance for hospitals implementing VBHC
Through mixed-methods research, we examine the decade-long (2012–2023) change towards VBHC at Erasmus Medical Center, a pioneering Dutch university hospital. This research investigates: (1) The evolution of the hospital's VBHC implementation strategy over the decade and its outcomes, analyzed through a complexity-lens; (2) Patient response rates to Patient Reported Outcome Measures (PROMs) and healthcare professionals' use of this data; (3) Strategies to improve PROMs use by patients and clinicians, including identifying patient and consultation characteristics associated with response behavior.
Gap 2: lack of clarity and consensus on VBHC in daily practice
In our Delphi study, clinicians identified 63 key activities essential for VBHC, emphasizing person-centered care, care optimization, and resource stewardship.
Gap 3: limited attention to healthcare professionals within VBHC
Through a systematic literature review and interview study, we examine the experiences of healthcare professionals in various (inter)national hospitals with VBHC, applying the Job Demands-Resources model. We find both positive and negative perceived impacts on their motivation, workload, and engagement, and describe the mechanisms behind these ‘gains’ and ‘pains.’
Key contributions of this thesis include framing VBHC as a goal-means hierarchy, applying insights from complexity theory to navigate the value movement, and emphasizing the importance of prioritizing the motivation, well-being and (re)professionalization of healthcare professionals.
| Original language | English |
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| Award date | 17 Apr 2025 |
| Place of Publication | Rotterdam |
| Publication status | Published - 17 Apr 2025 |