Antonio Giulio de Belvis- Fondazione Policlinico Universitario “A. Gemelli”, Università Cattolica del Sacro Cuore, Italian National Institute of Care and Research (IRCCS), Italian National Scientific Association of Quality on Health and Social Care (ASIQUAS) National Board, Rome, Italy
Editorial on the Research Topic
Value-based healthcare in oncology
Value in Healthcare, defined as the relationship between outcomes and costs (1), including direct financial costs and indirect costs such as impact on employment, treatment toxicity, and family/caregiver impact, remains a complex and multifaceted concept. Value-based healthcare is of primary importance in oncology as, over the past decades, neoplastic diseases have increased in incidence and prevalence, becoming one of the leading causes of death.
The objective of this Research Topic was to contribute to the existing body of knowledge with a clear picture of the current scenario of the Value-Based approach in oncologic clinical practice to deliver sound experience on its impact, potential benefits, challenges to address, and future research needs.
A total of 21 manuscripts were submitted, eleven of which were accepted.
Most of the contributions aimed at evaluating the economic efficacy or the financial impact of single/combined treatments of cancer diseases with a particular public health burden.
In other cases, authors shared the results of their research on the impacts of the application of effective models of value-based care (Bigi et al.); they analyzed a new tool to combine reported quality experiences and patient-reported outcomes (de Mattia et al.).
Also, organizational and financing implications from reshaping the delivery of healthcare services according to a Value-Based care approach have been published. For example, studies on the experience of involving patients and professionals in a co-constructed therapeutic pathway (Casà et al.); a Value-Based approach to untangle the full benefit of HPV-related cancers elimination strategies and identify priority and best practices (Calabrò et al.) have been reported, respectively.
Value-based healthcare in oncology still has some limits, as there remains no standard to quantify the many outcomes and cost components of value (i.e., patient-reported outcomes and estimated costs to patients), thus various conceptual frameworks have been proposed (2).
Furthermore, publishing has become more and more challenging and there are several reasons for the difficulties. I have encountered as an Editor that as a Public Health journal we cannot simply store papers that arrive spontaneously (even after a qualitative selection), and we tried to orient publishing according to validity, rigor, and relevance (3).
We also tried to challenge the public health research community to address future research needs, such as refinement of performance indicators to include patients' perspective (PROMS/PREMS); implementation of shared decision-making as routine in clinical practice; reshaping of logistics and operations to respect the values of “green” care delivery; digital support for the implementation of Value-Based approaches; reshaping of reimbursement systems to bundled payments based on clinical outcomes.
Indeed, we received a few feedbacks on some of these items.
Thus, from a public health perspective and by considering the great expansion of the research community, particularly from emerging countries and low-income countries, it will be crucial for healthcare organizations to use Value-based healthcare in oncology to improve the quality of care on an individual level and consider patients' concerns and needs; reduce unwarranted duplications and wastes in care provision via more regular or systematic assessment of the effectiveness of care and monitoring of disease progression; increase patient information, communication, and shared medical decision-making, thus paving the way for precision and personalized medicine.
Author contributions
AB: Writing—original draft, Writing—review and editing.
Acknowledgments
The author would like to thanks Stefano Villa, Annalisa Calabr, and Maria Rosaria Savarese for their kind aid as co-editors. A special thank to Alessio Perilli for his patient and smart collaboration.
Conflict of interest
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
1. Porter ME. What is value in health care? N Engl J Med. (2010) 363:2477–81. doi: 10.1056/NEJMp1011024
2. Allen CJ, Johnson FM, In H, Katz MHG, Snyder RA. Shifting the focus: value-based care in surgical oncology. Ann Surg Oncol. (2023) 30:3871–4. doi: 10.1245/s10434-023-13369-8
Keywords: value-based, healthcare, cancer, public health, patient centeredness
Citation: de Belvis AG (2023) Editorial: Value-based healthcare in oncology. Front. Public Health 11:1274409. doi: 10.3389/fpubh.2023.1274409
Received: 08 August 2023; Accepted: 24 August 2023;
Published: 13 September 2023.
Edited and reviewed by: Hai Fang, Peking University, China
Copyright © 2023 de Belvis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Antonio Giulio de Belvis, antonio.debelvis@unicatt.it