Achieving greater value and equity in health care

This issue of the Australian Health Review is the second themed issue on value-based care (see Australian Health Review, 2019, 43(5) for the first) and highlights the emerging expertise being developed amongst Australian researchers, policy makers and health service providers in crafting an approach to value in health care that is fit for purpose in the Australian health system.

While a substantial body of research now exists to inform the development of models of care which focus on the outcomes that matter to patients, the differences in governance, funding, data and workforce arrangements across countries have meant that there has been reservations about the opportunities to translate international evidence to practice in Australia.

The emerging Australian approach to value-based health care prioritises a patient-centric approach, as do programs internationally. However, the definition and measurement of value needs to take into account public good and societal value as well as value to individuals if Australia is to remain committed to universality and achieving greater equity in health care.¹

Importantly, this must include addressing some of the long-term challenges in the Australian health system, including the disparity in health outcomes between Aboriginal and Torres Strait Islanders Peoples and non-Indigenous Australians, and between people living in regional, rural and remote areas and those living in metropolitan settings.

Public policy efforts require an evidence base which is nuanced to the Australian context, and takes into account the unique challenges of a health system where responsibilities are spread across multiple jurisdictions and amongst private and public funders and providers.

The National Health Reform Agreement Addendum,² signed by all jurisdictions in July 2020, points the way towards a health system which prioritises the outcomes that matter to patients, and seeks to move from volume to value.

Australian health services and researchers are actively engaged in innovative work reflecting this interest in value-based health care. While many programs are still in their infancy, infrastructure is being developed;³ for example, relating to patient-reported outcome measures; innovative funding and collaborative commissioning models are being trialled; education programs are underway for health leaders; and formative evaluations of programs are providing guidance for implementation at scale.

Together with leading international academics and practitioners, health researchers and leaders from across Australia will meet in Perth in late May 2021 for Australia’s first national value-based health care conference (Fig. 1). They will share their research and experience in designing and implementing value-based health care programs. This is an important step towards developing an Australian knowledge base which will support the policy work being undertaken to achieve greater value in health care.

Fig. 1.  The Australian Health and Hospitals Association’s Value-Based Health Care Conference 2021.

Australian Health Review is the peer-reviewed journal of the Australian Healthcare and Hospitals Association, of which AV is Chief Executive.