Maximising Value in Healthcare Systems by Putting the Patient at the Centre – Systemic Design Considerations

Abstract

Value-based healthcare addresses inefficiencies, rising costs, and inconsistent quality by prioritising patient outcomes relative to costs. Despite broad support, its definition and implementation remain unclear. This perspective proposes a systemic, person-centred approach that aligns stakeholders around shared values. We examine frameworks like Berwick's ‘Triple Aim’ and Porter's patient-centred model, and integrat Sir Muir Gray's moral dimension for a holistic perspective. Achieving an effective system requires committed leadership, bottom-up redesign integrating all care levels, and cross-sector collaboration to align policies with sustainable health improvements. Context-sensitive metrics are essential to balancing patient-centred and economic value.