|
VALUE |
|
|
Bottom Line |
“…. value is expressed as what we gain relative to what we give up – the benefit relative to the cost.” Source: Institute of Medicine of the National Academies. (2008) Learning Healthcare System Concepts v. 2008. The Roundtable on Evidence-Based Medicine, Institute of Medicine. Annual Report. (p.21.) |
|
Significance
|
There are two different types of meaning. One may be called the principled meaning - such as “we value diversity”; the other is the economic meaning, the relationship between outcome and cost, in fund terms, or in everyday language, an Oxford English Dictionary example “we cannot be seen to lack value for money.
“One meaning of the word ‘value’ may be described as its moral meaning, namely ‘the status of a thing or the estimate in which it is held according to its real or supposed worth, usefulness, or importance’, the definition from the late Middle English. This use of the word ‘value’ is common in healthcare, for example the hospital which claims that ‘we value patient choice’, or ‘we value openness and honesty’.”
The second meaning in the Shorter English Dictionary can be described as the economic Meaning. One of the four variants that the Shorter English Dictionary gives is ‘that amount of some commodity, medium of exchange, etc. which is considered to be an equivalent for something else’, and it gives as an example of the meaning of the term the use in 1806, ‘we could hardly be said to have value for our money’. Source: Gray, J.A.M. (2007) How to Get Better Value Healthcare. Offox Press. (p.6). |
|
Examples of how the term is used; Extract from the Better Value Healthcare 21st Century Glossary |
“The concepts of utility and value are commonly used in two distinct senses: (a) experience value, the degree of pleasure or pain, satisfaction or anguish in the actual experience of an outcome; and (b) decision value, the contribution of an anticipated outcome to the overall attractiveness or aversiveness of an option in a choice.”
The purpose of health care is to enhance physical and mental health status. “Value in health care is expressed as the physical health and sense of wellbeing achieved relative to the cost. High value in health care therefore means getting the right care at the right time to the right patient for the right price.” Source: Institute of Medicine of the National Academies. (2008) Learning Healthcare System Concepts v. 2008. The Roundtable on Evidence-Based Medicine, Institute of Medicine. Annual Report. (p.21.)
“The concept of value combines quality and total cost: We have given a qualitative relationship here emphasizing the direct influence of quality and the inverse effect of total cost on value, but the precise relationship is usually more complex.”
“Value is not a bad word. When employers and insurance companies use the term, many providers suspect that it’s code for cost reduction. But Michael Porter, of Harvard Business School, and others have been pointing out for years that in healthcare, “value” means something else: achieving good outcomes as efficiently as possible. It may never be expressible as a numerical ratio (quality divided by costs) that allows meaningful comparisons among providers. But measuring outcomes and costs does allow providers to push for improvement – and to learn from their competitors.“ Source: Meyer C, Kirby J. (2010) Leadership in the Age of Transparency. Harvard Business Review. (p.52).
“Value in any field must be defined around the customer, not the supplier. Value must also be measured by outputs, not inputs. Hence it is patient health results that matter, not the volume of services delivered. But results are achieved at some cost. Therefore, the proper objective is the value of health care delivery, or the patient health outcomes relative to the total cost (inputs) of attaining those outcomes. Efficiency, then, is subsumed in the concept of value. So are other objectives like safety, which is one aspect of outcomes.” Source: Porter ME. (2008) What is Value in Health Care? Harvard Business School. Institute for Strategy and Competititveness. White Paper. |
