{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T06:52:50Z","timestamp":1781679170940,"version":"3.54.5"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"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>Objective<\/jats:title>\n                    <jats:p>This study aims to elucidate the connotations of Value-Based Healthcare (VBHC), correct misconceptions, and explore perceptual differences among distinct groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An analytical framework for VBHC connotations was first constructed from five perspectives: subject-object and subjective-objective relations, the individual and the collective, the refined value equation, conceptual categories and scope, and value implications. A questionnaire was then developed, and statistical analyses, including analysis of variance (ANOVA) and chi-square tests, were conducted on the collected survey data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant differences existed between older adults and other age groups regarding the public welfare orientation, equity, and cost perceptions. Perceptions of \u201cpatient-centeredness,\u201d subjective utility, and marginal value varied significantly by education, region, and urban\u2013rural residency. Compared to other cohorts, older adults prioritized health outcomes, and middle-aged to older groups focused on functional recovery, whereas survival duration was not a primary concern. Individuals with graduate degrees, the public, patients, and urban residents prioritized health outcomes; conversely, other groups balanced health outcomes and costs, though none prioritized costs alone. Healthcare leaders prioritized hospital expenses, whereas others prioritized patients\u2019 financial burdens. Although functional recovery was universally favored, urban residents valued survival duration, whereas county and township populations emphasized the likelihood of disease recurrence and recovery sustainability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>(1) Overall, respondents exhibited weak cost awareness; rather than prioritizing health outcomes or costs individually, they favored a balance between health outcomes and costs and prioritized functional recovery over survival duration. (2) Older adults and eastern populations leaned toward the individual, the public welfare orientation, and efficiency, whereas other age cohorts and western populations favored the collective, equity, and the public interest. Central populations focused on the collective but attempted to reconcile equity and efficiency, embodying a unique, moderate value paradigm. (3) Urban populations interpreted \u201cpatient-centeredness\u201d from a multi-stakeholder perspective, emphasizing objective health outcomes and survival duration, whereas county\/township populations more readily accepted subjective utility and diminishing marginal value, considering costs more frequently.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1866891","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:56:27Z","timestamp":1781675787000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The connotations of Value-Based Healthcare: interpretive perspectives and differences in perceptions"],"prefix":"10.3389","volume":"14","author":[{"given":"Wenneng","family":"Jiang","sequence":"first","affiliation":[{"name":"School of Public Health and Management, Guangxi University of Chinese Medicine","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuangshuang","family":"Lu","sequence":"additional","affiliation":[{"name":"School of Public Health and Management, Guangxi University of Chinese Medicine","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiying","family":"Xie","sequence":"additional","affiliation":[{"name":"School of Public Health and Management, Guangxi University of Chinese Medicine","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Shu","sequence":"additional","affiliation":[{"name":"School of Public Health and Management, Guangxi University of Chinese Medicine","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohui","family":"Song","sequence":"additional","affiliation":[{"name":"School of Public Health and Management, Guangxi University of Chinese Medicine","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"ref1","first-page":"98","volume-title":"Redefining Health Care: Creating Value-Based Competition on Results","author":"Porter","year":"2006"},{"key":"ref2","year":"2025"},{"key":"ref3","year":"2025"},{"key":"ref4","year":"2025"},{"key":"ref5","first-page":"56","article-title":"Let public hospitals return to the track of social public welfare","volume":"7","author":"Li","year":"2008","journal-title":"Qiushi"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"42","DOI":"10.14150\/j.cnki.1674-7453.2021.12.003","article-title":"On the reform of the public hospitals in the new era","volume":"12","author":"Li","year":"2021","journal-title":"Admin Reform"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"15","DOI":"10.19523\/j.jjkx.2013.06.005","article-title":"Practicing the essence of reform of the third plenary session: deepening national medical reform and avoiding misunderstanding blind spots","volume":"6","author":"Liu","year":"2013","journal-title":"Econ Sci"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"178","DOI":"10.19985\/j.cnki.cassjwe.2021.12.009","article-title":"The effects of the zero-markup drug policy on medical costs and quality of care","volume":"12","author":"He","year":"2021","journal-title":"J World Econ."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"224","DOI":"10.19985\/j.cnki.cassjwe.2025.07.006","article-title":"The impact of mandatory gatekeeping policy on hospital choices and medical expenditure","volume":"7","author":"Xiao","year":"2025","journal-title":"J World Econ"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e066568","DOI":"10.1136\/bmjopen-2022-066568","article-title":"Cost measurement in value-based healthcare: a systematic review","volume":"12","author":"Leusder","year":"2022","journal-title":"BMJ Open"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3969\/j.issn.1674-2982.2011.06.001","article-title":"What is value in health care","volume":"4","author":"Porter","year":"2011","journal-title":"Chin J Health Policy"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3969\/j.issn.2095-7432.2022.01.012","article-title":"Value-based medicine: concept and recent advances","volume":"12","author":"Gao","year":"2022","journal-title":"Chin J Med Manage Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.7507\/1007-9424.202111009","article-title":"The concept of value-based healthcare and its implementation pathways","volume":"28","author":"Gu","year":"2021","journal-title":"Chin J Bases Clin Gen Surg"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"22","DOI":"10.7664\/CHE20200105","article-title":"Review on the research progress of the value assessment framework","volume":"39","author":"Wang","year":"2020","journal-title":"Chin Health Econ"},{"key":"ref15","first-page":"50","article-title":"The strategy that will fix health care","volume":"91","author":"Porter","year":"2013","journal-title":"Harv Bus Rev"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.jval.2021.07.005","article-title":"What is value in health and healthcare? A systematic literature review of value assessment frameworks","volume":"25","author":"Zhang","year":"2022","journal-title":"Value Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"104918","DOI":"10.1016\/j.healthpol.2023.104918","article-title":"Building on value-based health care: towards a health system perspective","volume":"138","author":"Smith","year":"2023","journal-title":"Health Policy"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3969\/j.issn.10032800.2018.01.001","article-title":"Values of China's health and healthcare","volume":"32","author":"Hu","year":"2018","journal-title":"Soft Sci Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.14055\/j.cnki.33-1056\/f.2019.02.001","article-title":"Purchasing value-based medical and health services","volume":"36","author":"Hu","year":"2019","journal-title":"Health Econ Res"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e070193","DOI":"10.1136\/bmjopen-2022-070193","article-title":"Does value-based healthcare support patient-centred care? A scoping review of the evidence","volume":"13","author":"Kidanemariam","year":"2023","journal-title":"BMJ Open"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"6","DOI":"10.14055\/j.cnki.33-1056\/f.2019.02.002","article-title":"The concept, progress and practice path of value-based healthcare","volume":"36","author":"Jin","year":"2019","journal-title":"Health Econ Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"71","DOI":"10.7664\/CHE20180518","article-title":"Progress and enlightenment of value-based medical research","volume":"37","author":"Su","year":"2018","journal-title":"Chin Health Econ"},{"key":"ref23","first-page":"10","article-title":"Difficulties and methodological recommendations for value-based pricing of health care services","volume":"43","author":"Liang","year":"2024","journal-title":"Chin Health Econ"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"21","DOI":"10.3969\/j.issn.1003-2800.2019.12.005","article-title":"Practical research and enlightenment of medical service of American \"value medicine\"","volume":"33","author":"Fang","year":"2019","journal-title":"Soft Sci Health"},{"key":"ref25","volume-title":"Value in Health Care: Accounting for Cost, Quality, Safety, Outcomes, and Innovation","year":"2010"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1108\/LHS-07-2023-0051","article-title":"Untangling the perception of value in value-based healthcare\u2014an interview study","volume":"37","author":"Wolf","year":"2024","journal-title":"Leadersh Health Serv"},{"key":"ref27","first-page":"43","article-title":"Several issues regarding the essence of value","volume":"2008","author":"Wang","year":"2008","journal-title":"Acad Res"},{"key":"ref28","first-page":"16","article-title":"Value, value orientation and the socialist kernel values","volume":"2015","author":"Yang","year":"2015","journal-title":"J Beijing Norm Univ (Soc Sci)"},{"key":"ref29","first-page":"157","article-title":"Development of health technology assessment","volume":"16","author":"Dong","year":"2000","journal-title":"Chin J Hosp Admin"},{"key":"ref30","first-page":"392","volume-title":"The Marginal Revolution in Economics","author":"Shackle","year":"2016"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"58","DOI":"10.15894\/j.cnki.cn11-3040\/a.2011.06.018","article-title":"Public and publicity: a conceptual analysis","volume":"2011","author":"Ren","year":"2011","journal-title":"Marxism Real"},{"key":"ref32","first-page":"67","article-title":"Publicness: the foundation and core of public management research","volume":"2003","author":"Wang","year":"2003","journal-title":"Soc Sci"},{"key":"ref33","first-page":"4","article-title":"What is the substantial difference in nature of health care system between the social welfare and social philanthropy","volume":"27","author":"Liu","year":"2007","journal-title":"Chin Hosp Manage"},{"key":"ref34","first-page":"10","article-title":"Study on the definition and its enhancement options of public-interests orientation of public hospitals","volume":"31","author":"Lei","year":"2012","journal-title":"Chin Health Econ"},{"key":"ref35","first-page":"120","volume-title":"Understanding Value-Based Healthcare","author":"Moriates","year":"2018"},{"key":"ref36","first-page":"14","volume-title":"Deepening Medical and Health System Reform in China: Building a Value-Based Quality Service Delivery System","year":"2019"},{"key":"ref37","first-page":"111","volume-title":"Value-Based Healthcare in Progress","author":"Zhang","year":"2022"},{"key":"ref38","first-page":"20","volume-title":"The Quality Cure: How Focusing on Health Care Quality Can Save your Life and Lower Spending Too","author":"Cutler","year":"2022"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"22","DOI":"10.12014\/j.issn.1002-0772.2024.08.08","article-title":"Research on the application and issues of value-based healthcare in clinical practice in China","volume":"45","author":"Liu","year":"2024","journal-title":"Med Philos"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1866891\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:56:41Z","timestamp":1781675801000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1866891\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":39,"alternative-id":["10.3389\/fpubh.2026.1866891"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1866891","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"article-number":"1866891"}}