The rising cost of cancer care has shed light on an important aspect of healthcare delivery. Financial toxicity of therapy must be considered in clinical practice and policy-making. One way to mitigate the impact of financial toxicity of cancer care is by focusing on an approach of healthcare delivery that aims to deliver value to the patient. Should value of therapy be one of the most important determinants of cancer care? If so, how do we measure it? How can we implement it in routine clinical practice? In this viewpoint, we discuss value-based care in systemic therapy in oncology. Strategies to improve the quality of care by incorporating value-based approaches are discussed: use of composite tools to assess the value of drugs, alternative dosing strategies, and the use of Health Technology Assessment in regulatory procedures. We propose that there must be a greater emphasis on value of therapy in determining its use and its cost.
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http://dx.doi.org/10.3390/curroncol29080456 | DOI Listing |
Global Spine J
January 2025
Department of Rehabilitation Medicine, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA.
Study Design: Randomized Controlled Trial.
Objective: Chronic low back pain (CLBP) is a major public health concern that will continue to grow with the expected aging of the population. The purpose of this study was to examine the clinical effect of a personalized, home-based biomechanical intervention compared to traditional physical therapy in patients with CLBP.
J Bone Joint Surg Am
November 2024
Department of Orthopaedic Surgery, Harvard Medical School, Boston Shoulder Institute, Massachusetts General Hospital, Boston, Massachusetts.
Background: Rotator cuff repair (RCR) is a frequently performed outpatient orthopaedic surgery, with substantial financial implications for health-care systems. Time-driven activity-based costing (TDABC) is a method for nuanced cost analysis and is a valuable tool for strategic health-care decision-making. The aim of this study was to apply the TDABC methodology to RCR procedures to identify specific avenues to optimize cost-efficiency within the health-care system in 2 critical areas: (1) the reduction of variability in the episode duration, and (2) the standardization of suture anchor acquisition costs.
View Article and Find Full Text PDFHum Resour Health
January 2025
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Background: While aiming to optimize patient value, the shift towards Value-Based Health Care (VBHC) in hospitals worldwide has been argued to benefit healthcare professionals as well. However, robust evidence regarding VBHC's workforce implications is lacking. This gap is problematic, as the motivation and health of healthcare professionals are central to the quality of care and crucial amidst contemporary workforce challenges.
View Article and Find Full Text PDFBMC Musculoskelet Disord
January 2025
VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street MC: 6342, Redwood City, CA, 94603, USA.
Background: As value-based care arrangements continue to assess quality of care and costs, comprehensive and patient-centered definitions of quality of care are required. While patient-reported outcome measures are increasingly integrated into quality assessments following total joint arthroplasty (TJA), patient perceptions of quality paired with the phase of surgical care has not been described. The purpose of this study was to assess how TJA patients perceive measures of quality of care and assess if these perceptions change based on the phase of care.
View Article and Find Full Text PDFJ Am Acad Orthop Surg
January 2025
From the Department of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH (Pasqualini, Ibaseta, T Khan, and Piuzzi), the Case Western Reserve University School of Medicine, Cleveland, OH (Pan, Xu, and Austin), the Department of Orthopaedic Surgery, Larkin Community Hospital, South Miami, FL (Corces), and Levitetz Department of Orthopaedic Surgery, the Cleveland Clinic Florida, Weston, FL (Higuera).
Background: Total hip arthroplasty (THA) practices are evolving under the influence of the current value-based healthcare system and bundled payment models. This study aimed to (1) evaluate national trends in discharge disposition and postoperative outcomes after THA, (2) compare discharge cohorts on episode-of-care parameters, and (3) determine predictors of nonhome discharge from 2011 to 2021.
Methods: The National Surgical Quality Improvement Program database was queried for THA data from 2011 to 2021.
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