Creating patient value in glaucoma care: applying quality costing and care delivery value chain approaches A five‐year case study in the Rotterdam Eye Hospital

Creating patient value in glaucoma care: applying quality costing and care delivery value chain... Purpose – The purpose of this paper is to explore in a specific hospital care process the applicability in practice of the theories of quality costing and value chains. Design/methodology/approach – In a retrospective case study an in‐depth evaluation of the use of a quality cost model (QCM) and the applicability of Porter's care delivery value chain (CDVC) was performed in a specific care process: glaucoma care over the period 2001 to 2006 in the Rotterdam Eye Hospital in The Netherlands. Findings – The case study shows a reduction of costs per product by increasing the number of outpatient visits and surgery combined with a higher patient satisfaction. Reduction of costs of non‐compliance by using the QCM is small, due to the absence of (external) financial incentives for both the hospital and individual physicians. For CDVC to be supportive to an integrated quality and cost management the notion “patient value” needs far more specification as mutually agreed on by the stakeholders involved and related reimbursement needs to depend on realised outcomes. Research limitations/implications – The case study just focused on one specific care process in one hospital. To determine effects in other areas of health care, it is important to study the use and applicability of the QCM and the CDVC in other care processes and settings. Originality/value – QCM and a CDVC can be useful tools for hospital management to manage the outcomes on both quality and costs, but impact is dependent on the incentives in the context of the existing organisational and reimbursement system and asks for an agreed on operationalisation among the various stakeholders of the notion of patient value. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Health Care Quality Assurance Emerald Publishing

Creating patient value in glaucoma care: applying quality costing and care delivery value chain approaches A five‐year case study in the Rotterdam Eye Hospital

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Publisher
Emerald Publishing
Copyright
Copyright © 2009 Emerald Group Publishing Limited. All rights reserved.
ISSN
0952-6862
DOI
10.1108/09526860910953511
Publisher site
See Article on Publisher Site

Abstract

Purpose – The purpose of this paper is to explore in a specific hospital care process the applicability in practice of the theories of quality costing and value chains. Design/methodology/approach – In a retrospective case study an in‐depth evaluation of the use of a quality cost model (QCM) and the applicability of Porter's care delivery value chain (CDVC) was performed in a specific care process: glaucoma care over the period 2001 to 2006 in the Rotterdam Eye Hospital in The Netherlands. Findings – The case study shows a reduction of costs per product by increasing the number of outpatient visits and surgery combined with a higher patient satisfaction. Reduction of costs of non‐compliance by using the QCM is small, due to the absence of (external) financial incentives for both the hospital and individual physicians. For CDVC to be supportive to an integrated quality and cost management the notion “patient value” needs far more specification as mutually agreed on by the stakeholders involved and related reimbursement needs to depend on realised outcomes. Research limitations/implications – The case study just focused on one specific care process in one hospital. To determine effects in other areas of health care, it is important to study the use and applicability of the QCM and the CDVC in other care processes and settings. Originality/value – QCM and a CDVC can be useful tools for hospital management to manage the outcomes on both quality and costs, but impact is dependent on the incentives in the context of the existing organisational and reimbursement system and asks for an agreed on operationalisation among the various stakeholders of the notion of patient value.

Journal

International Journal of Health Care Quality AssuranceEmerald Publishing

Published: May 1, 2009

Keywords: Quality costs; Value chain; Health services; Eyes; The Netherlands

References

  • Incentives and financing methods
    Aas, I.H.M.
  • Quality Is Free
    Crosby, P.B.
  • What is the business care for improving care for patients with complex conditions?
    Luck, J.; Parkerton, P.; Hagigi, F.

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