ReviewFrontiers in public health2025
Toward value in healthcare: opportunities and challenges for implementing Value-Based Healthcare in North Macedonia.
Review in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- The health diplomacy spiral: a conceptual framework linking health system integration and public health diplomacy.Public health reviews · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: European healthcare systems face increasing pressures from ageing populations, chronic disease burdens, and rising costs. North Macedonia experiences similar challenges, including workforce shortages, limited economic growth, and persistent health inequalities. Although reforms such as the Diagnosis-Related Group payment system and the development of an e-health platform represent progress, major gaps remain: low public funding, high out-of-pocket spending, weak primary care, and poor data integration. This review analyses Value-Based Healthcare implementation in selected European countries and assesses the current state of the Macedonian health system to identify challenges and opportunities for Value-Based Healthcare. Methods: A two-step narrative approach was applied. Peer-reviewed literature on Value-Based Healthcare implementation in European countries was retrieved from PubMed, Scopus, and Web of Science, complemented by case studies and EIT Health handbook. To evaluate North Macedonia, policy documents and reports were reviewed from the World Health Organization, the European Observatory on Health Systems and Policies, the European Commission, and national authorities, including the Health Insurance Fund, the Institute of Public Health, and the Ministry of Health. Evidence was synthesized thematically across financing, digital infrastructure, outcome measurement, and governance. Results: Examples from Spain, the Netherlands, and Germany demonstrate the benefits of outcome measurement, integrated care delivery, and innovative payment models. Experiences from Bulgaria and Slovenia, with comparable health systems, provide additional lessons. Conclusion: Value-Based Healthcare implementation in North Macedonia will require greater public investment, stronger primary care, standardised outcome measurement, and robust digital infrastructure. Prioritising value-driven, patient-centered reforms could strengthen performance, equity, and sustainability.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.