Expert narrative review on the impact of value-based healthcare on medical quality and patient safety system restructuring

Value-based healthcare (VBHC) is critical for enhancing medical quality and patient safety. Integrating soft indicators like patient-reported outcomes (PROs) remains challenging due to methodological heterogeneity. This narrative review synthesizes evidence on the efficacy of VBHC interventions for improving medical quality and patient safety. A structured search of PubMed, Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov covered studies published from 2020 to 2024. The review included randomized trials and cohort studies. A total of 49 studies underwent thematic narrative synthesis. The study selection process was documented transparently, inspired by systematic review principles. Tools like risk-of-bias assessments provided contextual description. The synthesis included 49 studies (n = 15,392 participants). VBHC interventions appeared to improve detection rates and cooperation efficacy. They also enhanced safety culture and process metrics, but effect sizes varied. Substantial heterogeneity was noted. VBHC shows significant potential for enhancing medical quality and patient safety. However, evidence certainty remains moderate. Future work should prioritize standardized metrics and robust evaluations to bridge translational gaps.