Presentation (CTI)

OBJECTIVES: The Value-Based Healthcare (VBHC) framework strives to maximize patient value, defined as the ratio of all patient relevant health outcomes to the costs required to achieve these outcomes. Despite its potential, holistic measures of value are often lacking due to the multi-dimensional nature of this concept. This study aimed to assess and compare value creation for patients undergoing robot-assisted versus traditional Total Knee Replacement (TKR) surgery in a holistic way.
METHODS: We employed the novel four-step framework that integrates Time-Driven Activity-Based Costing with Data Envelopment Analysis to generate a single value score per patient. This comprehensive metric combines all costs and outcomes, facilitating benchmarking across patients based on created value. Six different health outcomes, including patient-reported outcomes, collected iteratively over a one-year period were linked to the total cost of care incurred during surgery and follow-up.
RESULTS: Value assessments were compared across the patient population and between the two interventions—robot-assisted and traditional surgery. Multiple value drivers, comprising patient, disease, and treatment characteristics, were identified as contributors to the observed variability in value. Our findings demonstrated that analysing a multi-dimensional outcome set yields different and more actionable insights than focusing solely on costs or primary outcomes, as is common in cost-utility and cost-effectiveness analyses.
CONCLUSIONS: This study underscores the importance of holistic evaluations of healthcare interventions. Considering costs or outcomes independently can lead to biased conclusions. The results provided the hospital with nuanced insights into which treatment modality offers greater value, tailored to specific patient profiles. These findings pave the way for more informed decision-making and optimized resource allocation in TKR procedures.