Redesigning cardiovascular healthcare: patient and professional perspectives on value

Abstract

Cardiovascular healthcare is continuously evolving. Biochemical,-and surgical discoveries from past decades improved patient survival to outstanding heights. However, with an ever growing aging patient population and scarce resources, cardiovascular healthcare has to become more value-driven. Value Based Healthcare (VBHC) research is becoming increasingly important in that matter, which questions the relevance (i.e. value) of contemporary evidence-based interventions in relation to patients’ health status and personal preferences.

It is difficult to obtain a comprehensive view of ‘valuable outcome’ for both patients and professionals as individual and subjective perspectives on the value of treatment are ever present. This thesis presents a methodological ‘toolbox’ to assess clinical cardiovascular care, unravel the ‘value of care’ for its stakeholders and develop it further in a meaningful way. Patients were assessed on a national level using claims data, which enables insight into care patterns and helps unravel if that which is perceived as valuable by the professional (i.e. guideline evidence), is truly applied in daily practice. Second, cardiovascular care on a local hospital level is qualitatively assessed via Human Factors (HF) science, a novelty in clinical research. In line with VBHC, it helps to understand how the patient and professional experience healthcare within a certain context.