The Influence of Value Perspectives on Decision-Making in the South African Private Healthcare Sector

Abstract

Value of Care can be expressed in an equation, whereby the numerator, outcomes, represents the Clinical Outcome of a care episode whilst the denominator, cost, refers to total Cost of the Clinical Event. PatientÕs Experience is acknowledged as contributing to value creation in healthcare, alongside clinical effectiveness (outcomes as a function of cost), but its impact remains understudied. Multiple stakeholders are at play in healthcare, including the consumer (patient) and provider (doctor). Oftentimes, stakeholders in healthcare have conflicting goals. A deeper understanding of the differences in value perspectives of key stakeholders in healthcare delivery is therefore required. Using the Value Perspectives Survey, this study explored differences in relative importance of three factors (Clinical Outcome, Cost of Clinical Event and PatientÕs Experience), identified as contributors to Value of Care, to gain insight into value perspectives of consumers (n = 662) and providers (n = 381) in the South African private healthcare context. Descriptive statistics were used to characterise the study sample and tests of mean differences were used to assess whether differences exist between consumers and providers in terms of value perspectives, as well as to assess differences in value perspectives as the severity of surgical and medical scenarios increase. The study concluded that PatientÕs Experience should be added as a factor in the healthcare value equation. Differences in value perspectives were demonstrated between consumers and providers in terms of the value attributed to Clinical Outcome, Cost of Clinical Event and PatientÕs Experience as well as with progression of severity in surgical and medical scenarios. The study concluded that the balance of factors can be utilised in evidence-based, multi-factor decision-making, by providers and consumers, thereby creating value. A better understanding of how value perspectives differ can inform value creation strategies in the South African private healthcare context.