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Table 1 Four discourses on VBHC

From: Redefining value: a discourse analysis on value-based health care

 

PEMP

GOV

PROF

CRI

VBHC

Framework for improving patients’ position regarding medical choices

Toolkit to steer and incentivize providers

Methodology for optimizing healthcare delivery

Dogma of manufacturability

Assumption

Patients in disadvantaged position, inequality in patient doctor relation

Incentives can improve behavior of medical professionals

Professionals intrinsically motivated to serve patients interest and deliver value

Health care is too complex for standardized value

Main use of outcome info

Choice information (for patients)

To stimulate professionals

Professional learning and improving

Learning and within patient-doctor relation

SDM

End goal: would require and demonstrate empowered patients.

Way to enable patients to act upon outcome information.

Way to improve care delivery and create value for individual patient.

Great: addressing individual needs in cooperative relation.