{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:00:38Z","timestamp":1792602038302,"version":"4.5.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Value-based healthcare (VBHC) proposes a framework for managing healthcare systems, connecting health and economic outcomes to determine the value of healthcare. The value equation remains ambiguous, serving more as a theoretical framework than a practical decision-making tool. The key challenge lies in estimating and interpreting the value equation. The purpose of this study is to provide a methodological proof-of-concept to address this gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of 330 patients diagnosed with breast cancer with a 12-month follow-up from two healthcare centres was used to illustrate the proposed approach. Patient-reported outcomes and economic-related outcomes (PROs and EROs) were collected. The numerator was defined as the patient-centred outcome-adjusted life years (PACELYs), a novel metric proposed here that combines PROs and survival, whilst the denominator was expressed in euros. Moving towards a marginal perspective, Incremental value (IV) and value curve were proposed as decision-making measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean PACELYs for healthcare centres A and B were between 69.85 and 73.24, and the costs for these centres were 12,129\u20ac\u201313,404\u20ac. The InIV showed that centre B generated an additional PACELY at 376\u20ac compared to A, reflecting differences in organisational efficiency. The value curve showed variation in efficiency across VBHC thresholds, depending on the healthcare context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This is the first proof-of-concept to estimate a value figure as a patient-centred efficiency measure for comparing healthcare providers within VBHC, with two pivotal transformations of the value equation: the use of PACELYs and the adoption of a marginal perspective, thereby positioning it as a decision-making tool in VBHC. The estimated figure will facilitate comprehensive benchmarking across centres and be applicable to other medical conditions. Further research should focus on designing value-based payment systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1696854","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:02:04Z","timestamp":1776085324000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Bringing the value equation into play in value-based healthcare"],"prefix":"10.3389","volume":"14","author":[{"given":"Borja","family":"Garc\u00eda-Lorenzo","sequence":"first","affiliation":[{"name":"Biosistemak Institute for Health System Research","place":["Bilbao, Basque Country, Spain"]},{"name":"Red de Investigacion en Cronicidad, Atencion Primaria y Promocion de la Salud RICAPPS-(RICORS), Instituto de Salud Carlos III (ISCIII)","place":["Madrid, 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Organisation","place":["Donostia-San Sebasti\u00e1n, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Varela-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Quality of Care Unit, Hospital Universitario 12 de Octubre","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"G\u00f3mez-Inhiesto","sequence":"additional","affiliation":[{"name":"Osakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation","place":["Barakaldo, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ane","family":"Fullaondo","sequence":"additional","affiliation":[{"name":"Biosistemak Institute for Health System Research","place":["Bilbao, Basque Country, Spain"]},{"name":"Red de Investigacion en Cronicidad, Atencion Primaria y Promocion de la Salud RICAPPS-(RICORS), Instituto de Salud Carlos III (ISCIII)","place":["Madrid, 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