Transforming Health Care Delivery towards Value-Based Health Care in Germany: A Delphi Survey among Stakeholders
Franziska Krebs,
Sabrina Engel,
Vera Vennedey,
Adrienne Alayli,
Dusan Simic,
Holger Pfaff,
Stephanie Stock,
on behalf of the Cologne Research and Development Network (CoRe-Net)
Affiliations
Franziska Krebs
Institute of Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Köln, Germany
Sabrina Engel
Institute of Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Köln, Germany
Vera Vennedey
Institute of Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Köln, Germany
Adrienne Alayli
Institute of Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Köln, Germany
Dusan Simic
Institute of Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Köln, Germany
Holger Pfaff
Faculty of Human Sciences and Faculty of Medicine, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, 50933 Köln, Germany
Stephanie Stock
Institute of Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Köln, Germany
on behalf of the Cologne Research and Development Network (CoRe-Net)
Value-based healthcare (VBC) represents one strategy to meet growing challenges in healthcare systems. To date, VBC is not implemented broadly in the German healthcare system. A Delphi survey was conducted to explore stakeholders’ perspectives on the relevance and feasibility of actions and practices related to the implementation of VBC in the German healthcare system. Panellists were selected using purposive sampling. Two iterative online survey rounds were conducted which were preceded by a literature search and semi-structured interviews. After two survey rounds, a consensus was reached on 95% of the items in terms of relevance and on 89% of the items regarding feasibility. The expert panels’ responses were in favor of the presented actions and practices of VBC in 98% of items for which consensus was found (n = 101). Opposition was present regarding the relevance of health care being provided preferably in one location for each indication. Additionally, the panel considered inter-sectoral joint budgets contingent on treatment outcomes achieved as not feasible. When planning the next steps in moving towards a value-based healthcare system, policymakers should take into account this study’s results on stakeholders’ perceptions of the relative importance and feasibility of VBC components. This ensures that regulatory changes are aligned with stakeholder values, facilitating greater acceptance and more successful implementation.