Value-based health care (VBHC) has become a widely popular framework to discuss health care delivery. It has been argued that the value generated (expressed as the health outcomes obtained divided by the cost associated with this) can be a common goal for payers and providers to unite around and that this would drive development towards a more efficient health care system. However, when going beyond the theoretical framework there are challenges to putting this in practice, at least if we want to know which provider delivers the highest value or if the value produced has improved over time. The reason for this is that within VBHC, health outcomes are multidimensional covering different aspects of health and recovery. How can we determine what provider within a group is the more successful if they overperform within a subset of outcomes but underperform in others? Measuring costs across the full value delivery chain can also be a very challenging undertaking. In this editorial, Lindgren and Althin discuss how we can draw upon well-established methods from productivity and efficiency research to answer questions like these. They argue that through the use of data envelop analysis (DEA) it is possible to compare providers delivering a range of different outcomes, and it is in fact possible to do this with out valuing the specific inputs used during this process thereby providing a very powerful tool for analysis of value delivery.
The European Journal of Health Economics (online ahead of print)