The Influence of Value Perspectives on Decision-Making in the South African Private Healthcare Sector

Abstract

Abstract Background Value of Care in healthcare can be expressed as the outcomes (Clinical Outcome) divided by the total cost (Cost of Clinical Event) of a care episode. Patient’s Experience, an understudied factor in healthcare, has also been acknowledged as a contributor, yet it has not been thoroughly explored in relation to Value of Care. Objectives This study focuses on two of the multiple stakeholders involved in healthcare: the consumer (patient), and the provider (doctor). Given that these two stakeholders often have conflicting goals, a deeper understanding of the differences in their value perspectives regarding healthcare delivery is imperative. Method Using a self-developed Value Perspectives Survey, this study explores the differences in relative importance of three factors (Clinical Outcome, Cost of Clinical Event, and Patient’s Experience) identified as contributors to Value of Care. The aim is to gain insight into value perspectives of consumers (n = 662) and providers (n = 381) in the South African private healthcare context. Descriptive statistics were used to characterise the sample, while tests of mean differences identified whether differences exist between consumers and providers in terms of value perspectives and assessed differences in value perspectives as the severity of surgical and medical scenarios increase. Results Findings suggest that Patient’s Experience must be considered in the healthcare value equation. Differences in value perspectives were demonstrated between consumers and providers, and with the progression of severity in surgical and medical scenarios for both groups. Conclusion Understanding differences in value perspectives between consumers and providers can inform evidence-based, multifactor decision-making, and can furthermore inform a better understanding of how value perspectives differ between consumers and providers can inform value creation strategies in the South African private healthcare delivery context. In turn, this can inform the alignment of the South African private healthcare sector to the proposed Universal Health Coverage model of National Health Insurance.