000064296 001__ 64296 000064296 005__ 20220111135612.0 000064296 0247_ $$2doi$$a10.1111/jep.12483 000064296 0248_ $$2sideral$$a95793 000064296 037__ $$aART-2017-95793 000064296 041__ $$aeng 000064296 100__ $$aParra Moncasi, E. 000064296 245__ $$aAssessing Value-based Health Care Delivery for Hemodialysis 000064296 260__ $$c2017 000064296 5060_ $$aAccess copy available to the general public$$fUnrestricted 000064296 5203_ $$aRationale, aims and objectives Disparities in haemodialysis outcomes among centres have been well-documented. Besides, attempts to assess haemodialysis results have been based on non-comprehensive methodologies. This study aimed to develop a comprehensive methodology for assessing haemodialysis centres, based on the value of health care. The value of health care is defined as the patient benefit from a specific medical intervention per monetary unit invested (Value = Patient Benefit/Cost). This study assessed the value of health care and ranked different haemodialysis centres. Method A nephrology quality management group identified the criteria for the assess- ment. An expert group composed of stakeholders (patients, clinicians and managers) agreed on the weighting of each variable, considering values and preferences. Multi-criteria methodology was used to analyse the data. Four criteria and their weights were identified: evidence-based clinical performance measures = 43 points; yearly mortality = 27 points; patient satisfaction = 13 points; and health-related quality of life = 17 points (100-point scale). Evidence-based clinical performance measures included five sub-criteria, with respective weights, including: dialysis adequacy; haemoglobin concentration; mineral and bone disorders; type of vascular access; and hospitalization rate. The patient benefit was determined from co-morbidity–adjusted results and corresponding weights. The cost of each centre was calculated as the average amount expended per patient per year. Results The study was conducted in five centres (1–5). After adjusting for co-morbidity, value of health care was calculated, and the centres were ranked. A multi-way sensitivity analysis that considered different weights (10–60% changes) and costs (changes of 10% in direct and 30% in allocated costs) showed that the methodology was robust. The rankings: 4-5-3-2-1 and 4-3-5-2-1 were observed in 62.21% and 21.55%, respectively, of simula- tions, when weights were varied by 60%. Conclusions Value assessments may integrate divergent stakeholder perceptions, create a context for improvement and aid in policy-making decisions. 000064296 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/ 000064296 590__ $$a1.483$$b2017 000064296 591__ $$aHEALTH CARE SCIENCES & SERVICES$$b67 / 94 = 0.713$$c2017$$dQ3$$eT3 000064296 591__ $$aMEDICINE, GENERAL & INTERNAL$$b81 / 154 = 0.526$$c2017$$dQ3$$eT2 000064296 591__ $$aMEDICAL INFORMATICS$$b18 / 25 = 0.72$$c2017$$dQ3$$eT3 000064296 592__ $$a0.641$$b2017 000064296 593__ $$aPublic Health, Environmental and Occupational Health$$c2017$$dQ2 000064296 593__ $$aHealth Policy$$c2017$$dQ2 000064296 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000064296 700__ $$aArenas, M.D. 000064296 700__ $$aAlonso, M. 000064296 700__ $$aMartínez, M.F. 000064296 700__ $$aGamen, A. 000064296 700__ $$0(orcid)0000-0003-3138-7597$$aAguarón, J.$$uUniversidad de Zaragoza 000064296 700__ $$0(orcid)0000-0003-4419-1905$$aEscobar, M.T.$$uUniversidad de Zaragoza 000064296 700__ $$0(orcid)0000-0002-5037-6976$$aMoreno-Jiménez, J.M.$$uUniversidad de Zaragoza 000064296 700__ $$aÁlvarez-Ude, F. 000064296 7102_ $$14008$$2623$$aUniversidad de Zaragoza$$bDpto. Estruc.Hª Econ.y Eco.Pb.$$cÁrea Métodos Cuant.Econ.Empres 000064296 773__ $$g23, 3 (2017), 477-485$$pJ. eval. clin. pract.$$tJOURNAL OF EVALUATION IN CLINICAL PRACTICE$$x1356-1294 000064296 8564_ $$s251702$$uhttps://zaguan.unizar.es/record/64296/files/texto_completo.pdf$$yVersión publicada 000064296 8564_ $$s92118$$uhttps://zaguan.unizar.es/record/64296/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000064296 909CO $$ooai:zaguan.unizar.es:64296$$particulos$$pdriver 000064296 951__ $$a2022-01-11-13:52:31 000064296 980__ $$aARTICLE