Gains and pains: a qualitative study on the implications of value-based health care for professionals
Abstract Background While aiming to optimize patient value, the shift towards Value-Based Health Care (VBHC) in hospitals worldwide has been argued to benefit healthcare professionals as well. However, robust evidence regarding VBHC’s workforce implications is lacking. This gap is problematic, as th...
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| Format: | Article |
| Language: | English |
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BMC
2025-01-01
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| Series: | Human Resources for Health |
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| Online Access: | https://doi.org/10.1186/s12960-025-00972-x |
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| author | Veerle van Engen Igna Bonfrer Fabio Mieris Malou Ensink Anne Stiggelbout Kees Ahaus Martina Buljac-Samardzic |
| author_facet | Veerle van Engen Igna Bonfrer Fabio Mieris Malou Ensink Anne Stiggelbout Kees Ahaus Martina Buljac-Samardzic |
| author_sort | Veerle van Engen |
| collection | DOAJ |
| description | Abstract Background While aiming to optimize patient value, the shift towards Value-Based Health Care (VBHC) in hospitals worldwide has been argued to benefit healthcare professionals as well. However, robust evidence regarding VBHC’s workforce implications is lacking. This gap is problematic, as the motivation and health of healthcare professionals are central to the quality of care and crucial amidst contemporary workforce challenges. This study aims to qualitatively examine the implications of VBHC for healthcare professionals’ motivation, job strain, and ongoing participation in VBHC. In addition, it explores how these outcomes are regulated at both the individual and organizational levels. Methods Semi-structured interviews were conducted with 26 healthcare professionals across six Dutch hospitals. Interviewees engaged in three VBHC activities: (1) value-based outpatient consultations and/or; (2) value-based quality improvement activities; as well as in; (3) VBHC implementation. Interview questions and data analysis were guided by the Job Demands–Resources model. Results VBHC interacts with four themes perceived to affect professional’s motivation (perception of making a positive impact, enjoyability of job activities, personal development, and sense of community and support) and three themes perceived to affect job strain (workload, cognitive demands, and confidence). VBHC creates both gains (primarily increasing motivation; occasionally reducing strain) and pains (primarily increasing strain; sometimes reducing motivation). The perceived impact of VBHC depends on the fit between the individual, one’s activities in VBHC, the working conditions, and the pace of VBHC implementation. An observation that warrants attention is that healthcare professionals with a 'do-er' mentality and high ambitions to optimize patient value can become demotivated to continue advancing VBHC with the same intensity, particularly due to perceived slow progress. Conclusions While VBHC is centered around patients, this study emphasizes that the needs, experiences and changing role identities of healthcare professionals cannot be overlooked in this transition. VBHC currently presents as a double-edged sword for healthcare professionals: resulting in both gains and pains. In the move to VBHC, it is crucial to maintain alignment between the individual, their job activities, the work environment, and the pace at which VBHC unfolds. This is essential for fostering and retaining motivated individuals, who are not only vital to the workforce but also pivotal in advancing VBHC. |
| format | Article |
| id | doaj-art-8730c001a292423bbe9db662f28a6d2e |
| institution | Kabale University |
| issn | 1478-4491 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Human Resources for Health |
| spelling | doaj-art-8730c001a292423bbe9db662f28a6d2e2025-01-19T12:25:58ZengBMCHuman Resources for Health1478-44912025-01-0123111210.1186/s12960-025-00972-xGains and pains: a qualitative study on the implications of value-based health care for professionalsVeerle van Engen0Igna Bonfrer1Fabio Mieris2Malou Ensink3Anne Stiggelbout4Kees Ahaus5Martina Buljac-Samardzic6Erasmus School of Health Policy & Management, Erasmus University RotterdamErasmus School of Health Policy & Management, Erasmus University RotterdamErasmus School of Health Policy & Management, Erasmus University RotterdamErasmus School of Health Policy & Management, Erasmus University RotterdamErasmus School of Health Policy & Management, Erasmus University RotterdamErasmus School of Health Policy & Management, Erasmus University RotterdamErasmus School of Health Policy & Management, Erasmus University RotterdamAbstract Background While aiming to optimize patient value, the shift towards Value-Based Health Care (VBHC) in hospitals worldwide has been argued to benefit healthcare professionals as well. However, robust evidence regarding VBHC’s workforce implications is lacking. This gap is problematic, as the motivation and health of healthcare professionals are central to the quality of care and crucial amidst contemporary workforce challenges. This study aims to qualitatively examine the implications of VBHC for healthcare professionals’ motivation, job strain, and ongoing participation in VBHC. In addition, it explores how these outcomes are regulated at both the individual and organizational levels. Methods Semi-structured interviews were conducted with 26 healthcare professionals across six Dutch hospitals. Interviewees engaged in three VBHC activities: (1) value-based outpatient consultations and/or; (2) value-based quality improvement activities; as well as in; (3) VBHC implementation. Interview questions and data analysis were guided by the Job Demands–Resources model. Results VBHC interacts with four themes perceived to affect professional’s motivation (perception of making a positive impact, enjoyability of job activities, personal development, and sense of community and support) and three themes perceived to affect job strain (workload, cognitive demands, and confidence). VBHC creates both gains (primarily increasing motivation; occasionally reducing strain) and pains (primarily increasing strain; sometimes reducing motivation). The perceived impact of VBHC depends on the fit between the individual, one’s activities in VBHC, the working conditions, and the pace of VBHC implementation. An observation that warrants attention is that healthcare professionals with a 'do-er' mentality and high ambitions to optimize patient value can become demotivated to continue advancing VBHC with the same intensity, particularly due to perceived slow progress. Conclusions While VBHC is centered around patients, this study emphasizes that the needs, experiences and changing role identities of healthcare professionals cannot be overlooked in this transition. VBHC currently presents as a double-edged sword for healthcare professionals: resulting in both gains and pains. In the move to VBHC, it is crucial to maintain alignment between the individual, their job activities, the work environment, and the pace at which VBHC unfolds. This is essential for fostering and retaining motivated individuals, who are not only vital to the workforce but also pivotal in advancing VBHC.https://doi.org/10.1186/s12960-025-00972-xValue-based health careHealthcare professionalMotivationStrainExperienceDemands |
| spellingShingle | Veerle van Engen Igna Bonfrer Fabio Mieris Malou Ensink Anne Stiggelbout Kees Ahaus Martina Buljac-Samardzic Gains and pains: a qualitative study on the implications of value-based health care for professionals Human Resources for Health Value-based health care Healthcare professional Motivation Strain Experience Demands |
| title | Gains and pains: a qualitative study on the implications of value-based health care for professionals |
| title_full | Gains and pains: a qualitative study on the implications of value-based health care for professionals |
| title_fullStr | Gains and pains: a qualitative study on the implications of value-based health care for professionals |
| title_full_unstemmed | Gains and pains: a qualitative study on the implications of value-based health care for professionals |
| title_short | Gains and pains: a qualitative study on the implications of value-based health care for professionals |
| title_sort | gains and pains a qualitative study on the implications of value based health care for professionals |
| topic | Value-based health care Healthcare professional Motivation Strain Experience Demands |
| url | https://doi.org/10.1186/s12960-025-00972-x |
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