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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

Online
ISSN
1437-4331
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Volume 57, Issue 6

Issues

Value-based healthcare: the role of laboratory medicine

Federico Pennestrì / Giuseppe Banfi
  • Corresponding author
  • IRCCS Orthopedic Institute Galeazzi, Milan, Italy
  • Vita-Salute San Raffaele University, 20132 Milan, Italy
  • Email
  • Other articles by this author:
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Published Online: 2019-02-09 | DOI: https://doi.org/10.1515/cclm-2018-1245

Abstract

The global increase of health demands pushes administrators and policy makers to provide good quality health care at sustainable costs. Many approaches have been developed, among which value-based health care (VBHC) is one of the most promising: value is given by outcomes achieved per dollar spent. Best value is given by shared benefits between all the stakeholders involved in the process: patients, providers, suppliers, payers and citizens. However, VBHC implementation is a current challenge for hospitals and healthcare providers, that may find it difficult to adapt their organization into a patient-centered clinical pathway based on both classical outcomes and innovative patient-evaluation. If any contribution to improve cost-effectiveness over the full cycle of care is welcome, laboratory medicine is achieving increasing importance, by generating useful knowledge to reduce costs and improve patient care, provided by a biunivocal relationship with clinicians. On the one hand, pathologists have to emphasize the importance of laboratory data to improve diagnostic and prognostic traditional thinking. On the other hand, the same data are useful only when supported by strong evidence. Introducing laboratory medicine professionals to VBHC would be useful to achieve better skills on data outline, comparable methodologies, quality control, cost assessment, multidisciplinary coordination and patient-specific procedures.

Keywords: cost-effectiveness; ethics; laboratory medicine; patient-reported outcomes; sustainability; value-based health care

References

  • 1.

    Porter ME, Teisberg EO. Redefining competition in health care. Harv Bus Rev 2004;82:64–76.PubMedGoogle Scholar

  • 2.

    Nwachukwu BU, Hamid KS, Bozic KJ. Measuring value in orthopaedic surgery. J Bone Joint Surg Br 2013;1:1–9.Google Scholar

  • 3.

    Akhavan S, Ward L, Bozic KJ. Time-driven activity-based costing more accurately reflects costs in arthroplasty surgery. Clin Orthop Relat Res 2016;474:8–15.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 4.

    Brazier JE, Roberts J. The estimation of a preference-based measure of health from the SF-12. Med Care 2004;42:851–9.PubMedCrossrefGoogle Scholar

  • 5.

    Naessens JM, Van Such MB, Nesse RE, Dilling JA, Swensen SJ, Thompson KM, et al. Looking under the streetlight? a framework for differentiating performance measures by level of care in a value-based payment environment. Acad Med 2017;92:943–50.Web of ScienceCrossrefGoogle Scholar

  • 6.

    Porter ME. What is value in health care? New Engl J Med 2010;363:2477–81.Web of ScienceCrossrefGoogle Scholar

  • 7.

    Porter ME, Larsson S, Lee TH. Standardizing patient outcomes measurement. N Engl J Med 2016;374:504–6.CrossrefWeb of SciencePubMedGoogle Scholar

  • 8.

    International Consortium for Health Outcomes Measurement. https://www.ichom.org/standard-sets/#about-standard-sets. Accessed: 19 Nov 2018. To date, ICHOM published 26 Standard Sets, covering different conditions and specific-patient populations.

  • 9.

    Black N. Patient reported outcome measures could help transform healthcare. Br Med J 2013;346:f167.Web of ScienceCrossrefGoogle Scholar

  • 10.

    Lynch S. Measures need to capture patient’s view and experiences more effectively. Br Med J 2013;346:f1553.CrossrefGoogle Scholar

  • 11.

    D’Ambrosi R, Banfi G, Usuelli FG. Total ankle arthroplasties and national registers: what is the impact on scientific production? Foot Ankle Surg 2018 Mar 6. pii: S1268-7731(18)30046-8. doi: 10.1016/j.fas.2018.02.016. [Epub ahead of print].Google Scholar

  • 12.

    Dui LG, Cabitza F, Berjano P. Minimal important difference in outcome of disc degenerative disease treatment: the patient’s perspective. Stud Health Technol Inform 2018;247:321–5.Google Scholar

  • 13.

    Christalle E, Zeh S, Hahwleg P, Kriston L, Harter M, Scholl I. Assessment of patient centredness through patient-reporter experience measures (ASPIRES): protocol of a mixed-methods study. BMJ Open 2018;8:e025896.CrossrefGoogle Scholar

  • 14.

    Male L, Noble A, Atkinson J, Marson T. Measuring patient experience: a systematic review to evaluate psychometric properties of patient reported experience measures (PREMs) for emergency care service provision. Int J Qual Health Care 2017;29:314–26.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 15.

    Bozic KJ, Ward L. A strategy for successful implementation of bundled payments in orthopaedic surgery. J Bone Joint Surg Br 2014;2:e2.Google Scholar

  • 16.

    Ducatman AM, Tacker DH, Ducatman BS, Long D, Perrotta PL, Lawther H, et al. Quality improvement intervention for reduction of redundant testing. Acad Pathol. 2017;4:1–10.Web of ScienceGoogle Scholar

  • 17.

    Schmidt RL, Ashwood ER. Laboratory medicine and value-based health care. Am J Clin Pathol 2015;144:357–8.Web of ScienceCrossrefPubMedGoogle Scholar

  • 18.

    Crawford JM, Shotorbani K, Sharma G, Crossey M, Kothari T, Lorey TS, et al. Improving american healthcare through “Clinical Lab 2.0”: A Project Santa Fe Report. Acad Pathol 2017;4:1–8.Web of ScienceGoogle Scholar

  • 19.

    Risin SA, Chang BN, Welsh KJ, Kidd LR, Moreno V, Chen L, et al. Exploring new ways to deliver value to healthcare organizations: algorithmic testing, data integrating, and diagnostic e-consult service. Ann Clinc Lab Sci 2015;45:239–47.Google Scholar

  • 20.

    Brunetti M, Pregno S, Schünemann H, Plebani M, Trenti T. Economic evidence in decision-making process in laboratory medicine. Clin Chem Lab Med 2011;49:617–21.Web of SciencePubMedGoogle Scholar

  • 21.

    Brunetti M, Shemilt I, Pregno S, Vale L, Oxman AD, Lord J, et al. GRADE guidleines: 10. Considering resource use and rating the quality of economic evidence. J Clin Epidemiol 2013;66:140–50.CrossrefGoogle Scholar

  • 22.

    Summers SM, Long B, April MD, Koyfman A, Hunter CJ. High sensitivity troponin: the Sisyphean pursuit of zero percent miss rate for acute coronary syndrome in ED. Am J Emerg Med 2018;36:1088–97.CrossrefWeb of SciencePubMedGoogle Scholar

  • 23.

    Korley FK, Jaffe AS. High sensitivity cardiac troponin assays – how to implement them successfully. EJIFCC 2016;27:217–23.PubMedGoogle Scholar

  • 24.

    Lippi G, Plebani M. Diabetes alert dogs: a narrative critical overview. Clin Chem Lab Med 2019;57:45–8.Web of ScienceGoogle Scholar

  • 25.

    Rubinstein M, Hirsch R, Bandyopadhyay K, Madison B, Taylor T, Ranne A, et al. Effectiveness of practices to support appropriate laboratory tests utilizations: a laboratory medicine best practices systematic review and meta-analysis. Am J Clin Pathol 2018;149:197–221.CrossrefGoogle Scholar

  • 26.

    Miller KL. Patient centered care: a path to better health outcomes through engagement and activation. NeuroRehabilitation 2016;39:465–70.Web of ScienceCrossrefPubMedGoogle Scholar

  • 27.

    Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev 2012;70:351–79.Web of SciencePubMedGoogle Scholar

  • 28.

    Hudon C, Fortin M, Haggerty J, Loignon C, Lambert M, Poitras ME. Patient-centered care in chronic disease management: A thematic analysis of the literature in family medicine. Patient Educ Couns 2012;88:170–6.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 29.

    Epstein RM, Franks P, Fiscella K, Shields CG, Meldrum SC, Kravitz RL, et al. Measuring patient-centered communication in Patient-Physician consultations: theoretical and practical issues. Soc Sci Med 2005;61:1516–28.CrossrefPubMedGoogle Scholar

  • 30.

    Mead N, Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med 2000;51:1087–100.PubMedCrossrefGoogle Scholar

  • 31.

    Chaitoff A, Rothberg MB, Windover AK, Calabrese L, Misra-Hebert AD, Martinez KA. Physician empathy is not associated with laboratory outcomes in diabetes: a cross-sectional study. J Gen Intern Med 2019;34:75–81. PubMedCrossrefWeb of ScienceGoogle Scholar

  • 32.

    Monaghan PJ, Lord SJ, St John A, Sandberg S, Cobbaert CM, Lennartz L, et al. Biomarker development targeting unmet clinical needs. Clin Chem Acta 2016;460:211–9.CrossrefGoogle Scholar

  • 33.

    Horvath AR, Lord SJ, St John A, Sandberg S, Cobbaert CM, Lorenz S, et al. Test Evaluation Working Group of the European Federation of Clinical Chemistry and Laboratory Medicine. Clin Chim Acta 2014;427:49–57.Google Scholar

  • 34.

    Monaghan PJ, Robinson S, Rajdl D, Bossuyt PM, Sandberg S, St John A, et al. Practical guide for identifying unmet clinical needs for biomarkers. EJIFCC 2018;29:129–37.PubMedGoogle Scholar

  • 35.

    Plebani M. Quality and future of clinical laboratories: the Vico’s whole cyclical theory of the recurring cycles. Clin Chem Lab Med 2018;56:901–8.Web of ScienceCrossrefPubMedGoogle Scholar

About the article

Received: 2018-11-20

Accepted: 2018-12-27

Published Online: 2019-02-09

Published in Print: 2019-05-27


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 6, Pages 798–801, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2018-1245.

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