Key Factors in the Implementation of Value-Based Healthcare Performance Evaluation in General Hospitals Healthcare Groups: A Mixed Methodology Study

Abstract

Objective: To identify the principal factors influencing the implementation of high-value healthcare performance evaluation and to examine the interrelationships among these factors. Background: Value-based health care (VBHC) is gaining momentum as a model that focuses on improving patient outcomes. However, there is still a lack of understanding of the multifaceted factors that contribute to its successful implementation. Design: Theoretical modelling and mixed research methods. Methods: First, this study constructed a framework of influencing factors on the implementation of VBHC performance evaluation based on the Technology-Organization-Environment model. Second, a representative set of influencing factors for healthcare performance evaluation was identified. The implementation of performance evaluation was identified based on a literature analysis and a case study in China. Finally, experts were invited to assess the relevance of the aforementioned influencing factors, and the collected data were analysed using Interpretative Structural Model. The PRISMA-ScR checklist guided the reporting of this study. Results: We initially constructed the theory framework with the objective of categorising and summarising the influential factors and potential problems revealed in the implementation of patient VBHC performance evaluation in general hospitals. Subsequently, 15 key factors were identified through interviews with 10 experts. Then, a six-level hierarchy was developed to construct a visual structure diagram, the purpose of which was to clarify the hierarchy of roles of each influencing factor. Finally, we categorise the influencing factors into four clusters based on their driving power and dependency within the system. Conclusion: The insights from this research will assist hospital managers in identifying and prioritising the key factors that influence high-value healthcare performance. Relevance to Clinical Practice: This study provides a reliable pathway reference for clinical and nursing performance value enhancement and provides important insights into resource allocation and decision-making for clinical practitioners. Patient or Public Contribution: No patient or public contribution.