Identifying and Improving Value in Patients with Chronic Disease

Abstract

More than 10 million children in the USA have a chronic condition that requires healthcare. Children with chronic illness require distinct strategies to achieve best outcomes. Value, defined as outcome and patient experience divided by the cost of health care value, has emerged as a critical metric in health care and may be very applicable to the population of children with chronic conditions. With increased value, the patient, provider, and payer should benefit. While the concept of a value metric has face validity, the definition and application face challenges. The perspective of the payer, provider, health care system and the patient and family are not always aligned. Patient-centered care requires that the provider respect patient’s preferences and that care is integrated and coordinated. Quality of life, plays a critical role in decision-making especially with chronic disease management. At the population level, a value metric, if validated, might be able to forecast the impact of distinct improvement efforts and help to prioritize their efforts. The role of value as a driving force in health care is clear both at the individual and at the population level. Understanding value will improve decision-making but the details of the metric must be carefully validated at the condition level.