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Title: Translating value-based healthcare into practice
Authors: Bonde, Morten
Bossen, Claus
Danholt, Peter
Issue Date: 2017
metadata.dc.relation.ispartof: Infrahealth 2017 - Proceedings of the 6th International Workshop on Infrastructure in Healthcare 2017
Series/Report no.: Reports of the European Society for Socially Embedded Technologies: vol. 1, no. 1
Abstract: In this paper, we report from an experiment into healthcare governance called ‘new governance in the patient’s perspective’ (NG) initiated by a Danish Region. The experiment was inspired by principles of value-based health care (VBHC), and initiated to transform governance from a productivity-regime, allegedly incentivizing clinical conduct in ‘perverse’ and counter-productive ways, towards a new regime focusing on value for the patient. Pursuing this ambition the Region exempted nine hospital departments from activity-based financing based on Diagnosis-Related Groups (DRG), and asked instead the departments to develop self-chosen indicators to measure and account for ‘value for the patient’. Drawing on the notion of ‘translation’ (Latour, 1987) we analyse how NG was put into practice in the departments, and how their indicators were accounted for. Relating to literature on performance indicators, our case seemingly confirms a wellestablished distinction between indicators for internal improvement vs. external accountability. However, in pointing out the dialogues facilitated by the indicators between the Region and the departments, this distinction is challenged. Our analysis provides inspiration for healthcare governance to think of indicators as means, not for purely data-driven governance, but for dialogical practices in which concerns with accountability and local quality improvement conflate.
metadata.dc.identifier.doi: 10.18420/ihc2017_012
ISSN: 2510-2591
metadata.mci.conference.location: University of Aarhus, Denmark 22-23rd June 2017
Appears in Collections:InfraHealth 2017: Proceedings of the 6th International Workshop on Infrastructures for Healthcare

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