Value-based healthcare for social insurance medicine: key enablers for adoption in practice
Background Driven by rising retirement age and increasing prevalence of chronic diseases impacting work participation, there is an increasing need for quality and efficiency improvement in social insurance medicine (SIM). SIM provides guidance to individuals facing long-term work disability, assess...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/13/4/e002878.full |
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| author | Sylvia J van der Burg-Vermeulen Philip J van der Wees Jan L Hoving Nina Zipfel Marijke Melles Marije E Hagendijk |
| author_facet | Sylvia J van der Burg-Vermeulen Philip J van der Wees Jan L Hoving Nina Zipfel Marijke Melles Marije E Hagendijk |
| author_sort | Sylvia J van der Burg-Vermeulen |
| collection | DOAJ |
| description | Background Driven by rising retirement age and increasing prevalence of chronic diseases impacting work participation, there is an increasing need for quality and efficiency improvement in social insurance medicine (SIM). SIM provides guidance to individuals facing long-term work disability, assess their functional abilities and eligibility for long-term disability benefits. Value-based healthcare (VBHC) targets quality and efficiency improvements in healthcare by placing a priority on improving patient value. So far, VBHC has been introduced with fundamental principles and essential components for its adoption in curative care. Hence, there is room for debate on what are key enablers for the adoption of value-based SIM.Purpose The study aims to explore key enablers for the adoption of VBHC in the practice of SIM.Methods In this exploratory qualitative study, participants consisted of 15 professionals with expertise either in SIM (n=10) or with expertise in the adoption of VBHC in the curative care sector (n=5). Each participant took part in both a semistructured individual interview and a focus group interview. Thematic coding was employed to analyse the data.Results Seven key enablers were identified: (1) investigate the meaning and implementation constraints of value in SIM, (2) integrate SIM into work-focused care networks, (3) explore the need and feasibility for specialisation based on functional problems, (4) identify the most important work outcomes for the patient, (5) identify proxy indicators for cost drivers, (6) identify value-driven financial incentives and (7) develop an information technology system to exchange data.Conclusions This paper provides understanding of what is needed to adopt value-based SIM. Future research should delve deeper into these seven key enablers to facilitate the adoption of VBHC, and thereby promote value creation in the practice of SIM. |
| format | Article |
| id | doaj-art-cad22653e0c447b9a95e1a743c0f7109 |
| institution | Kabale University |
| issn | 2399-6641 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-cad22653e0c447b9a95e1a743c0f71092025-01-14T21:55:09ZengBMJ Publishing GroupBMJ Open Quality2399-66412024-12-0113410.1136/bmjoq-2024-002878Value-based healthcare for social insurance medicine: key enablers for adoption in practiceSylvia J van der Burg-Vermeulen0Philip J van der Wees1Jan L Hoving2Nina Zipfel3Marijke Melles4Marije E Hagendijk5Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The NetherlandsScientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Centre, Nijmegen, The NetherlandsDepartment of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The NetherlandsDepartment of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The NetherlandsFaculty of Industrial Design Engineering, Delft University of Technology, Delft, The NetherlandsDepartment of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The NetherlandsBackground Driven by rising retirement age and increasing prevalence of chronic diseases impacting work participation, there is an increasing need for quality and efficiency improvement in social insurance medicine (SIM). SIM provides guidance to individuals facing long-term work disability, assess their functional abilities and eligibility for long-term disability benefits. Value-based healthcare (VBHC) targets quality and efficiency improvements in healthcare by placing a priority on improving patient value. So far, VBHC has been introduced with fundamental principles and essential components for its adoption in curative care. Hence, there is room for debate on what are key enablers for the adoption of value-based SIM.Purpose The study aims to explore key enablers for the adoption of VBHC in the practice of SIM.Methods In this exploratory qualitative study, participants consisted of 15 professionals with expertise either in SIM (n=10) or with expertise in the adoption of VBHC in the curative care sector (n=5). Each participant took part in both a semistructured individual interview and a focus group interview. Thematic coding was employed to analyse the data.Results Seven key enablers were identified: (1) investigate the meaning and implementation constraints of value in SIM, (2) integrate SIM into work-focused care networks, (3) explore the need and feasibility for specialisation based on functional problems, (4) identify the most important work outcomes for the patient, (5) identify proxy indicators for cost drivers, (6) identify value-driven financial incentives and (7) develop an information technology system to exchange data.Conclusions This paper provides understanding of what is needed to adopt value-based SIM. Future research should delve deeper into these seven key enablers to facilitate the adoption of VBHC, and thereby promote value creation in the practice of SIM.https://bmjopenquality.bmj.com/content/13/4/e002878.full |
| spellingShingle | Sylvia J van der Burg-Vermeulen Philip J van der Wees Jan L Hoving Nina Zipfel Marijke Melles Marije E Hagendijk Value-based healthcare for social insurance medicine: key enablers for adoption in practice BMJ Open Quality |
| title | Value-based healthcare for social insurance medicine: key enablers for adoption in practice |
| title_full | Value-based healthcare for social insurance medicine: key enablers for adoption in practice |
| title_fullStr | Value-based healthcare for social insurance medicine: key enablers for adoption in practice |
| title_full_unstemmed | Value-based healthcare for social insurance medicine: key enablers for adoption in practice |
| title_short | Value-based healthcare for social insurance medicine: key enablers for adoption in practice |
| title_sort | value based healthcare for social insurance medicine key enablers for adoption in practice |
| url | https://bmjopenquality.bmj.com/content/13/4/e002878.full |
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