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FrancoAngeli Journals

Saggi

No. 126 (2023)

The value-based healthcare model in the redesign of healthcare production processes: Which lessons from a multiple case study?

DOI
https://doi.org/10.3280/mesa2023-126oa17279
Submitted
February 15, 2024
Published
2024-04-24

Abstract

The goal of the present study is to investigate – using a multiple-case study – the impact and the organizational conditions of the implementation of the value-based healthcare model. In particular, the study analyses the Multiple Myeloma (MM) an oncological disease that poses the same challenges modern healthcare systems are now facing in the post-pandemic era. To achieve these goals authors (i) have mapped the entire clinical process; (ii) have measured the total process cost using the time driven activity based costing technique; (iii) have identified the most relevant organizational conditions with particular reference to multidisciplinary teams and focused-hospital. The main evidence of the study can be summarized around two broad key-messages. First, the costs’ analysis shows that, with unchanged nursing and clinical casemix, different clinical and organizational choices do have a relevant economic and organizational impact. It is, thus, necessary, to standardize, where possible, the healthcare production processes through tools like clinical pathways. As we have learnt during the recent COVID-19 pandemic, the models of focused-hospital and multi-disciplinary teams represent effective solutions for the management of complex clinical conditions. The study identifies at least two organizational conditions that are relevant, it is, in fact, necessary to: i) develop “horizontal” ICT systems able to provide prompt and accurate data on care processes; ii) transfer to the primary care sector where possible – through also the help of technology (e.g. telemedicine) – the highly specialized competences of focused-hospital within a comprehensive (the full cycle of care) and integrated approach.

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