Desenvolvimento e validação de questionário sobre práticas de saúde baseada em valor em hospital filantrópico.

Abstract

Introduction: Brazilian hospitals have evolved from healthcare institutions to complex and professionalized organizations, a transformation often viewed as a conflict between financial sustainability and the healthcare mission. The philanthropic status led hospitals into a historic financial crisis due to the economic-financial imbalance of contracts with the Unified Health System (UHS) (Sistema Único de Saúde, SUS). The Covid-19 pandemic resulted in prolonged hospitalizations for the treatment of Non-Communicable Diseases (NCDs), with high costs, in patients who could have been managed by Primary Care. Volume-based healthcare practices waste essential resources and compromise the quality of care. The concept of Value-Based Health Care (VBHC) redefines the focus towards delivering better patient outcomes based on their health conditions, at a lower cost. Objective: Development and validation of a questionnaire on value-based healthcare practices in a philanthropic hospital. Manuscript: Organizational culture oriented toward the VBHC model in healthcare institutions. Book chapter (e-book): Value-based health care, beyond cost and price. Objective: to present the fundamentals of VBHC and its importance to the Brazilian healthcare system, facing an aging population as well as increased NCDs cases and COVID-19 impacts. Methods: it is a chapter published in an e-book focused on a literature review on the principles, challenges and perspectives of the VBHC model, highlighting its emphasis on patient-centered care, on the service quality and on the efficiency of resource use, with focus on the cultural transformation and collaboration between the organizations in the healthcare system. Conclusion: The VBHC model represents a promising alternative for prioritizing the quality and effectiveness of care, fostering a more sustainable healthcare system. General conclusions: This research successfully validated a questionnaire to assess the existence of practices aligned with VBHC in health care institutions, providing a reliable and replicable tool. Its application in a philanthropic hospital offered a useful diagnosis for managers, identifying perceptions of the model across different professional groups. The development of the questionnaire encountered challenges in translating theoretical concepts into measurable items, underscoring the need for caution when analyzing the results due to the subjectivity of the responses. This study opens opportunities for future research, such as the replication of the instrument in various healthcare organizations and the monitoring of cultural changes over time.