Anais
Resumo do trabalho
Estratégia em Organizações · Processo Estratégico nas Organizações
Título
Value-Based Healthcare from a Management Perspective: A Systematic Review and Proposal for an Integrative Framework
Palavras-chave
VHBC
sistematic review
integrative framework
Agradecimento:
This research was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazil.
Autores
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Daniele Soutilha de Souza LudwigUNIVERSIDADE DO GRANDE RIO PROFESSOR JOSÉ DE SOUZA HERDY (UNIGRANRIO)
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Roberto P Q FalcaoUNIVERSIDADE DO GRANDE RIO PROFESSOR JOSÉ DE SOUZA HERDY (UNIGRANRIO)
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Bernardo Silva-RêgoUNIVERSIDADE DO GRANDE RIO PROFESSOR JOSÉ DE SOUZA HERDY (UNIGRANRIO)
Resumo
Introdução
The Value-Based Healthcare (VBHC) model proposes the reorganization of health systems to maximize clinical outcomes in relation to the costs involved, promoting greater efficiency and quality of care. Although widely disseminated in medical literature and health policy, there remains a lack of studies exploring VBHC from a management perspective, particularly regarding its implementation as a systemic process of organizational transformation.
Problema de Pesquisa e Objetivo
Despite the growing prominence of VBHC as a paradigm for health system improvement, its practical adoption still faces challenges when viewed through a managerial lens. The literature reveals conceptual fragmentation and a lack of integrated approaches. This study aims to analyze how VBHC has been addressed in administrative sciences and to propose a framework that connects VBHC to General Systems Theory (GST), supporting its implementation in a more systemic and sustainable manner.
Fundamentação Teórica
General Systems Theory (GST) is adopted as the theoretical foundation to understand health systems as dynamic, adaptive, and interdependent networks. This perspective helps overcome fragmented approaches by integrating clinical, organizational, cultural, and technological dimensions of the VBHC model. Additionally, insights from Soft Systems Thinking and creative holism reinforce the need for multiple lenses in analyzing complex contexts such as healthcare. Study follows PRISMA (2020) to review 68 VBHC articles from a management and systemic perspective.
Discussão
VBHC uptake remains fragmentary; clinical pilots advance, but governance, IT, and culture trail, limiting systemic value. GST reveals missing feedback loops linking micro bedside innovation with macro finance and regulation. Our integrative framework maps these interdependencies, giving managers a diagnostic roadmap. Yet generalizability is untested, and data-privacy constraints may hinder digital scaling. Future research should employ longitudinal, multi-site cases to validate mechanisms and explore patient co-creation incentives.
Conclusão
The findings indicate that VBHC, although widely promoted, still lacks an organizational model that integrates its multiple dimensions. Based on General Systems Theory and the Porter and Lee Value Agenda, an integrative framework is proposed to articulate the identified transformation drivers, reinforcing the need for adaptive, interdisciplinary, and context-sensitive approaches to enable sustainable adoption of the model.
Contribuição / Impacto
The study offers three main contributions: (1) theoretical, by proposing an integrative model grounded in GST and the Value Agenda; (2) managerial, by providing a strategic tool to guide VBHC implementation in healthcare organizations; and (3) institutional, by identifying systemic factors that can support the development of public policies aimed at sustainable value-based models.
Referências Bibliográficas
Abdelfadil, Babiker Ibrahim, Roderick Thomas, Daniel Rees, e Abubakr Suliman. 2023. “Opportunities and Challenges to the Implementation of Value-Based Healthcare (VBHC) in SMES: The Case of the State of Qatar”. Studies in Business and Economics 18(2): 5–23. doi:10.2478/sbe-2023-0021.
Porter, Michael E., e H. Lee Thomas. 2013. “The Strategy That Will Fix Health Care”. Harvard business review Harvard Business Review(10): 50–70.
Bertalanffy, Ludwig von. 2009. General System Theory: Foundations, Development, Applications. Rev. ed., 17. paperback print. New York, NY: Braziller.
Porter, Michael E., e H. Lee Thomas. 2013. “The Strategy That Will Fix Health Care”. Harvard business review Harvard Business Review(10): 50–70.
Bertalanffy, Ludwig von. 2009. General System Theory: Foundations, Development, Applications. Rev. ed., 17. paperback print. New York, NY: Braziller.