The implementation of Value-based Health Care in the Netherlands
Client: National Health Care Institute (Zorginstituut Nederland)
Value-based health care (VBHC) has seen a remarkable upsurge in recognition over the last decade. In the Netherlands, official policy initiatives are based on the model, while at the same time several care providers have also started to make use of it. The overall goal is clear: to improve the quality of care for patients while controlling costs. However, despite the widespread appreciation of VBHC, it is not a clear-cut concept. Instead, the contested nature of VBHC is shown in the multifarious and fragmented processes of adoption and implementation.
This project revolves around the contested implementation of VBHC; we are interested in the way(s) VBHC is understood and shaped by actors and organizations that have an impact on the quality of care in the Netherlands. In addition, we want to explore how and if the model can be of added value to patients. Moreover, we aim to provide insight into the extent to which VBHC could become a governance mechanism that guarantees qualitative and affordable care.
In order to explore the disputes on VBHC in the Netherlands, this project will start with a discourse analysis, focusing on umbrella organizations and governing bodies that are currently involved with the model. In a subsequent phase the attention will shift toward patients. With a particular focus on their daily lives, we aim to further an emic perspective on patient-value in relation to practices of VBHC. This is where the research gains a more ethnographic character, something that will continue when the emphasis is placed on the doctor’s office – the site where patient-value genuinely ought to emerge.
Gijs Steinmann (PhD Candidate), Dr. Hester van de Bovenkamp, Prof. dr. Diana Delnoij, Prof. dr. Antoinette de Bont.