Comparison of disease prioritization approaches for piloting value-based healthcare. Experience of international projects

Despite multiple international projects aimed at developing standards and pilot introduction of value-based healthcare, there is no systematic understanding of approaches for selection of priority diseases or conditions at baseline phase of implementing this model. The objective of this review is analyze and systematize approaches to selecting diseases/conditions for baseline (pilot) implementation of value-based healthcare, as used by leading international project initiatives. We analyzed materials from three initiatives: the International Consortium for Health Outcomes Measurement (ICHOM), projects supported by the United Nations Institute for Training and Research (UNITAR), and the Health Outcomes Observatory (H2O). A qualitative content analysis followed by thematic grouping of the identified criteria was used. Five key categories of criteria used in selecting the areas for value-based healthcare implementation were systematized: 1) epidemiological and medical-social significance; 2) potential for improving the quality and effectiveness of medical care; 3) organizational and technical feasibility; 4) quality and practical applicability of data set; 5) engagement of key stakeholders. Approaches to selecting diseases for value-based healthcare piloting are adaptive and project-oriented. They largely depend on operational goals and context of a specific initiative. Identifying and systematizing the key criteria form methodological basis for planning further research and substantiating disease prioritization within value-based healthcare implementation at the level of certain medical organizations and other project initiatives.