A framework for measuring health system value: Working paper

Overview

Saudi Arabia is carrying out a wide-ranging health system transformation. The achievement of better value (i.e. population and individual outcomes achieved for the resources invested) is a goal central to this transformation. The outcomes achieved by the health system, and the costs incurred, need to be measured and reported consistently to understand and demonstrate the impacts of the transformation.

In the working paper A framework for measuring health system value, Value in Health addresses the topic of value measurement and invites input from stakeholders on the way forward on this topic. It is timely to assess current progress and plans for outcome and costs measurement, to confirm the system has what is needed to evidence the delivery of better value. A common framework for measurement, based on the definition of value for Saudi Arabia, would be beneficial. Both clinical and patient-reported outcomes should be measured. The quantification of costs should consider both financial and non-financial resources. Consistent measurement will enable benchmarking and improvement. Where gaps are identified, we should look to global and national best practices to inform the implementation of Saudi Arabia’s plans for value measurement.

Value in Health proposes that particular and individual attention be given to six domains for value measurement: macro (national); meso (networks and Models of Care); micro (clinical microsystems); non-healthcare social determinants of health; configuration and transformation; periodic and one-off research. The trade-offs should be balanced: between the granularity and timeliness of comprehensive, detailed, real-time measures, and the potential burdens of excessive data collection and clarity offered by more focused data collection of only highest priority metrics. Global experience suggests that value measurement is a substantial technical and change management challenge, and it is the change management aspects that are prone to be overlooked. Stakeholders should now convene to align on preferred approaches to strengthen value measurement.

This working paper will be relevant for policymakers, leaders in provider organizations in public and private sectors, and those responsible for leading individual clinical services. Value in Health welcomes stakeholder input in response to this paper, as this will shape our future activities in the Measuring Health Value research program.