May value-based healthcare practices contribute to comprehensive care for cancer patients? A systematic literature review.

Background: The cancer incidence and mortality have increased both due to aging and population growth. There is an imbalance between this increasing incidence, the costs and the available budget. It highlights the importance of a value-based healthcare (VBHC) agenda, where value is what matters to patients, represented by outcomes over costs.

Objective: To identify how VBHC has been discussed in the context of cancer care and which practices could contribute to project value-based cancer care models.

Method: This article conducted a Systematic Literature Review (SLR) on SCOPUS (n = 168 results) and PubMed (n = 222), between 1995 and 2020, using PRISMA Protocol; and analyzed the results through VOSviewer and Bibliometrix in R, in addition to qualitative analysis for classification of practices.

Results: The main themes were 'Costs' (34%), 'Outcomes' (24%), 'VBHC agenda' (24%), 'models of care' (18%). 19 practices were identified and classified into 5 categories of operations: process technology and patient pathway, information and systems management, patient care scheduling and monitoring, performance measurement and quality management and network and integration.

Conclusion: The SLR points to the absence of a value-based care model for cancer patients, but the adherence to elements of the value agenda is an issue and currently a challenge. Costs are the main concerns, although this research does not identify significant structural changes. This research contributes to highlighting the gaps between theory and practice and it can be used as an input for designing value-based care services for cancer patients, as it synthesizes current practices and the main premises for implementing value agenda.