Value-based healthcare in Latin America: a survey of 70 healthcare provider organisations from Argentina, Brazil, Chile, Colombia and Mexico
Objectives Value-based healthcare (VBHC) is a health system reform gradually being implemented in health systems worldwide. A previous national-level survey has shown that Latin American countries were in the early stages of alignment with VBHC. Data at the healthcare provider organisations (HPOs) l...
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| Format: | Article |
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e058198.full |
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| author | Pedro Ramos Marcia Makdisse Daniel Malheiro Marcelo Katz Luisa Novoa Miguel Cendoroglo Neto Jose Henrique Germann Ferreira Sidney Klajner |
| author_facet | Pedro Ramos Marcia Makdisse Daniel Malheiro Marcelo Katz Luisa Novoa Miguel Cendoroglo Neto Jose Henrique Germann Ferreira Sidney Klajner |
| author_sort | Pedro Ramos |
| collection | DOAJ |
| description | Objectives Value-based healthcare (VBHC) is a health system reform gradually being implemented in health systems worldwide. A previous national-level survey has shown that Latin American countries were in the early stages of alignment with VBHC. Data at the healthcare provider organisations (HPOs) level are lacking. This study aim was to investigate how HPOs in five Latin American countries are implementing VBHC.Design Mixed-methods research was conducted using online questionnaire, semistructured interviews based on selected elements of the value agenda (from December 2018 to June 2020), analyses of aggregated data and documents. Qualitative analysis was performed using NVivo QSR International, 1.6.1 (4830). Quantitative analysis used Fisher’s exact test. Univariate analysis was used to compare organisations in relation to the implementation of VBHC initiatives. A p≤0.05 was considered significant.Participants Top and middle-level executives from 70 HPOs from Argentina, Brazil, Chile, Colombia and Mexico.Results The definition of VBHC varied across participating organisations. Although the value equation had been cited by 24% of participants, its composition differed in most case from the original Equation. Most VBHC initiatives were related to care delivery organisation (56.9%) and outcomes measurement (22.4%) but in most cases, integrated practice unit features had not been fully developed and outcome data was not used to guide improvement. Information, stakeholders buy-in, compensation and fragmented care delivery were the most cited challenges to VBHC implementation. Fee-for-service predominated, although one-third of organisations were experimenting with alternative payment models.Conclusions A wide variation in the definition and level of VBHC implementation existed across organisations. Our finding suggests investments in information systems and on education of key stakeholders will be key to foster VBHC implementation in the region. Further research is needed to identify successful implementation cases that may serve as regional benchmark for other Latin American organisations advancing with VBHC. |
| format | Article |
| id | doaj-art-34abd3dfc394499c8dfd2c364baf525e |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-34abd3dfc394499c8dfd2c364baf525e2025-01-27T14:10:08ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-058198Value-based healthcare in Latin America: a survey of 70 healthcare provider organisations from Argentina, Brazil, Chile, Colombia and MexicoPedro Ramos0Marcia Makdisse1Daniel Malheiro2Marcelo Katz3Luisa Novoa4Miguel Cendoroglo Neto5Jose Henrique Germann Ferreira6Sidney Klajner71CDI Labs, Mayaguez, Puerto Rico, USAHospital Israelita Albert Einstein, Sao Paulo, BrazilHospital Israelita Albert Einstein, Sao Paulo, BrazilHospital Israelita Albert Einstein, Sao Paulo, BrazilHospital Israelita Albert Einstein, Sao Paulo, BrazilQualidade e Segurança do Paciente, Hospital Israelita Albert Einstein, São Paulo, BrazilHospital Israelita Albert Einstein, Sao Paulo, BrazilHospital Israelita Albert Einstein, São Paulo, BrazilObjectives Value-based healthcare (VBHC) is a health system reform gradually being implemented in health systems worldwide. A previous national-level survey has shown that Latin American countries were in the early stages of alignment with VBHC. Data at the healthcare provider organisations (HPOs) level are lacking. This study aim was to investigate how HPOs in five Latin American countries are implementing VBHC.Design Mixed-methods research was conducted using online questionnaire, semistructured interviews based on selected elements of the value agenda (from December 2018 to June 2020), analyses of aggregated data and documents. Qualitative analysis was performed using NVivo QSR International, 1.6.1 (4830). Quantitative analysis used Fisher’s exact test. Univariate analysis was used to compare organisations in relation to the implementation of VBHC initiatives. A p≤0.05 was considered significant.Participants Top and middle-level executives from 70 HPOs from Argentina, Brazil, Chile, Colombia and Mexico.Results The definition of VBHC varied across participating organisations. Although the value equation had been cited by 24% of participants, its composition differed in most case from the original Equation. Most VBHC initiatives were related to care delivery organisation (56.9%) and outcomes measurement (22.4%) but in most cases, integrated practice unit features had not been fully developed and outcome data was not used to guide improvement. Information, stakeholders buy-in, compensation and fragmented care delivery were the most cited challenges to VBHC implementation. Fee-for-service predominated, although one-third of organisations were experimenting with alternative payment models.Conclusions A wide variation in the definition and level of VBHC implementation existed across organisations. Our finding suggests investments in information systems and on education of key stakeholders will be key to foster VBHC implementation in the region. Further research is needed to identify successful implementation cases that may serve as regional benchmark for other Latin American organisations advancing with VBHC.https://bmjopen.bmj.com/content/12/6/e058198.full |
| spellingShingle | Pedro Ramos Marcia Makdisse Daniel Malheiro Marcelo Katz Luisa Novoa Miguel Cendoroglo Neto Jose Henrique Germann Ferreira Sidney Klajner Value-based healthcare in Latin America: a survey of 70 healthcare provider organisations from Argentina, Brazil, Chile, Colombia and Mexico BMJ Open |
| title | Value-based healthcare in Latin America: a survey of 70 healthcare provider organisations from Argentina, Brazil, Chile, Colombia and Mexico |
| title_full | Value-based healthcare in Latin America: a survey of 70 healthcare provider organisations from Argentina, Brazil, Chile, Colombia and Mexico |
| title_fullStr | Value-based healthcare in Latin America: a survey of 70 healthcare provider organisations from Argentina, Brazil, Chile, Colombia and Mexico |
| title_full_unstemmed | Value-based healthcare in Latin America: a survey of 70 healthcare provider organisations from Argentina, Brazil, Chile, Colombia and Mexico |
| title_short | Value-based healthcare in Latin America: a survey of 70 healthcare provider organisations from Argentina, Brazil, Chile, Colombia and Mexico |
| title_sort | value based healthcare in latin america a survey of 70 healthcare provider organisations from argentina brazil chile colombia and mexico |
| url | https://bmjopen.bmj.com/content/12/6/e058198.full |
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