SAÚDE BASEADA EM VALOR

Value-based healthcare (VBHC) is a model that rewards providers and technologies capable of delivering results for the patient. The aim of this study was to identify the degree of knowledge about concepts related to different VBHC domains: doctors’, managers’ and pharmaceutical industry’s perspectives. Stakeholders from various areas of health systems in Brazil were interviewed between December 2018 and March 2019 about their knowledge in different domains related to organizational structure, management and VBHC management. One hundred stakeholders were contacted and 36 submitted questionnaire replies. For organizational domain, the items with the highest agreement were follow-up of clinical protocols and associated costs (median 8.0) and models applied for payment for performance between providers and health care insurers (8.0). Regarding which items are important to the company's management process, the financial impact of new incorporations, the clinical, economic and financial comparators between the technologies of the same clinical protocol, the improvement of the healthcare quality and the economic follow-up of the companies were highlighted. adverse effects, all with median 10.0. For the VBHC domain, we highlight the follow-up of patients' clinical outcomes, cost-effectiveness data, patient satisfaction, improved medical care, and clinical and economic follow-up of adverse effects, all also with median 10.0. Few stakeholders are concerned with providing better services, while many are focusing on reducing costs. Engaging all actors in health system to promote a shared vision of value and efficiency is determinant to succeed in VBHC models implementation.