Every one is concerned with the cost of care.
Even physicians are concerned with cost of care. There is a group of physicians advocating “Better care. Better Health. Lower cost. Working together we can improve the safety, affordability and experience of healthcare.” (http://www.costsofcare.org/home)
How do one control the costs of health care?
Cost-effectiveness is one strategy. Cost-efficiency is another strategy. Still another one is value-based health care services.
Cost-effectiveness and cost-efficiency are oftentimes used interchangeably. However, strictly speaking there is a difference.
Cost-effectiveness in health care is the extent to which an intervention has achieved or is expected to achieve its results (outcomes of the intervention) at lower cost compared to another alternative intervention.
Cost-efficiency in health care is the extent to which an intervention has achieved or is expected to achieve in converting resources / inputs (such as time and efforts) at lower cost compared to another alternative intervention. Put in another way, the most cost-efficient intervention is one that achieves the maximum possible outputs with minimum possible inputs. The most cost-efficient intervention is the most economical.
It is not easy to compute for the cost-effective and cost-efficient interventions in health care as one has to factor in the perceptions of the health care providers and the patients on what constitutes the best outcomes of care. The perceptions usually differ from one health care provider to another and from one patient to another. All these perceptions can be summed up in one word: value or in one term: value-for-money and in one theme: value-based health care services.
Value-based health care services is basing health care on values where value is defined as the health outcomes achieved that matter to patients relative to the cost of achieving those outcomes.
Value-based health care services is basing health care on value.
Value in health care services are defined differently by various institutions and various authors.
University of Utah Health Sciences
It is important to emphasize that the value in health care should take into account the perspectives of the patients or clients. They usually have different perspectives. Some prefer more expensive tests and procedures; some less expensive. Some do not mind a long operative scar as long the results are good and comparable to another procedure with small scar and expenses are lower.
Aside from the usual methods of promoting quality, safety and patient experience, for the medical management, the most practical approach is to present the options of diagnostic tests and treatment procedures with comparative data on benefit, risk, cost and availability. Then, the patients and relatives are asked what they want. In essence, this is informed consent with patient’s decision on what they value. This is a simple method of facilitating achievement of value in health care.