Changing by asking the patient A qualitative study on introduction of Value-based healthcare at a Swedish hospital

Abstract

Value-based healthcare (VBHC) is a concept which describes a new way to manage hospitals and puts focus on the patient value. The goal is to achieve as much of this patient value as possible for the cost of healthcare. Recently several hospitals in Sweden have started working with the concept, but little is known about the effects on Swedish healthcare practices and patients caused by the implementation and how the concept translates to practice for healthcare professionals. In this qualitative study, the data has been collected by conducting interviews with 20 respondents, including hospital employees of varying professions and two consultants involved in the pilot stages of implementation, along with two observations. Using the grounded theory approach, the data has been coded systematically in order to conduct our analysis. By analyzing the data through the lens of translation and identity creation we found that there are some differences among the respondents regarding the understanding of the VBHC concept and what it means within the context of the hospital. The local contexts’ of the patient group, and their different circumstances lead patient groups into translating VBHC differently and this caused practices themselves to vary. However, by changing practices and listening to the patient perspective, there was a change of mindset among the professionals, an effect on the role of the patient, as well as the relationships between professionals and patients. This study has contributed to the lack of research on the process of introducing Value-based healthcare and given some new insight on important factors to consider when introducing VBHC.