Identifying the Dimensions of a Value-Based Care Organization in Patients with Breast Cancer: Findings from a Qualitative Study (Preprint)

<sec> <title>BACKGROUND</title> The rising costs of breast cancer treatment, along with patients’ dissatisfaction regarding quality of care, have become significant challenges for Iran’s health system. </sec> <sec> <title>OBJECTIVE</title> This study aimed to identify the key dimensions of value-based care within Iran’s healthcare system and to develop a conceptual model for its implementation in breast cancer patients. </sec> <sec> <title>METHODS</title> This qualitative research was conducted through semi-structured interviews with 20 participants, including physicians, managers, nurses, psychologists, a physiotherapist, and informed patients. Participants were selected by purposive sampling, and interviews continued until theoretical saturation was reached. Data collection and analysis were performed concurrently using open, axial, and selective coding. To ensure the credibility of findings, member checking, participant review, and collaborative analysis were employed. </sec> <sec> <title>RESULTS</title> Data analysis resulted in the extraction of 739 initial codes, 152 concepts, 25 subcategories, and finally 5 main categories: "Ethical and Professional Standards," "Financial and Managerial Support," "Patient and Family Engagement," "Provision of Appropriate Services and Facilities," and "Quality and Reliability of Services." These categories reflected a wide range of concerns among patients, healthcare providers, and managers, including treatment equity, access to medications, insurance coverage, gender-sensitive care, family involvement, and deployment of skilled personnel. </sec> <sec> <title>CONCLUSIONS</title> The findings suggest that the successful implementation of value-based care in Iran’s health system requires simultaneous attention to cultural, structural, managerial, and human factors. A clear understanding of patient priorities, active stakeholder participation, and the development of supportive and technological infrastructures are essential for effective application of this model in breast cancer care. </sec>