Mapping the extent, range and nature of research activity on value-based healthcare in the 15 years following its introduction (2006-2021): a scoping review.

Objectives: We aimed to systematically map the extent, range and nature of research activity on value-based healthcare (VBHC), and to identify research gaps.

Design: A scoping review with an additional cited reference search was conducted, guided by the Joanna Briggs Institute methodology.

Data Sources: The search was undertaken in PubMed, Embase and Web of Science.

Eligibility Criteria: Eligible articles mentioned VBHC or value with reference to the work of Porter or provided a definition of VBHC or value.

Data Extraction And Synthesis: Data were independently extracted using a data extraction form. Two independent reviewers double extracted data from 10% of the articles. Data of the remaining articles (90%) were extracted by one reviewer and checked by a second. The strategic agenda of Porter and Lee was used to categorise the included articles.

Results: The searches yielded a total of 27,931 articles, of which 1,242 were analysed. Most articles were published in North America. Most articles described an application of VBHC by measuring outcomes and costs (agenda item 2). The other agenda items were far less frequently described or implemented. Most of these articles were conceptual, meaning that nothing was actually changed or implemented.

Conclusion: The number of publications increased steadily after the introduction of VBHC in 2006. Almost one-fifth of the articles could not be categorised in one of the items of the strategic agenda, which may lead to the conclusion that the current strategic agenda could be extended. In addition, a practical roadmap or guideline to implement VBHC is still lacking. Future research could fill this gap by specifically studying the effectiveness of VBHC in day-to-day clinical practice.