The Meaning of Value in “Person-centred” approaches to Healthcare

Abstract

In health economics, value has usually been understood within the framework of the production and consumption of healthcare. Two tools of measurement, efficiency and equity, have been used to make decisions on healthcare resources. However, the healthcare system is also not a market like others, and applying the criteria of efficiency and equity to the field of health calls for significant adaptation. In addition, even when epistemologically informed and technically equipped, care is also attention and an engagement toward the person for whom the care is directed. Current models fail to take into consideration the individual, qualitative nature of individual patient experience, but also the wider environment affecting the patient’s health outcomes. Therefore tensions continue to exist between value as understood in a health economics perspective and the relational values promoted in proposals of person-centered care. Healthcare values are plural and explain what one commits to in terms of actions and relationships with others. Taking into account this plurality reminds us both of the ethical dimension of care but also how it is made possible through financing. Person-centered care therefore calls for new models of evaluation, ones which will understand the values of care for the person in their personal and professional contexts.