Using Value to Assess Improvement in Healthcare; But What Counts As ‘Value’?

We contribute to the literature by advancing the debate on valuing healthcare and its relevance to assessing improvement. A systematic literature review includes academic papers and reported case-based information. We examine the potential contribution of subjective (qualitative) insights to valuing healthcare and to healthcare decisions, explicitly incorporate all stakeholders’ perceptions of the treatment process and health outcomes and explore the issues raised by illustrating an inclusive approach to making healthcare decisions. The insights afforded present “value” as a multidimensional concept, which relies on objective and subjective elements and the assessment of which is open to differing interpretations. We propose that researchers and healthcare professionals adopt mixed methods (quantitative and qualitative approaches) to collect measurements and stakeholder perceptions of health outcomes, treatment processes and attendant costs. While recognizing that the explicit inclusion of treatment processes and of stakeholders’ perceptions alongside economic and accounting measures may present reporting challenges, we argue that it has the potential to lead to better decisions