Evidence map›Paper›PMID 42052032›Full record

ArticleFrontiers in public health2026

Bringing the value equation into play in value-based healthcare.

Borja García-Lorenzo, Arantzazu Arrospide, Iker Ustarroz-Aguirre, Ania Gorostiza, Itxaso Alayo, Teresa Acaiturri-Ayesta, Marisol Blanco, Izaskun Etxezarreta, Carolina Varela-Rodríguez, Elisa Gómez-Inhiesto and 2 more

Abstract read
In one paragraph

Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Borja García-LorenzoBiosistemak Institute for Health System Research, Bilbao, Basque Country, Spain.
Arantzazu ArrospideBiosistemak Institute for Health System Research, Bilbao, Basque Country, Spain.
Iker Ustarroz-AguirreOsakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation, Barakaldo, Spain.
Ania GorostizaBiosistemak Institute for Health System Research, Bilbao, Basque Country, Spain.
Itxaso AlayoBiosistemak Institute for Health System Research, Bilbao, Basque Country, Spain.
Teresa Acaiturri-AyestaOsakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation, Barakaldo, Spain.
Marisol BlancoOsakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia-San Sebastián, Spain.
Izaskun EtxezarretaOsakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia-San Sebastián, Spain.
Carolina Varela-RodríguezQuality of Care Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
Elisa Gómez-InhiestoOsakidetza Basque Health Service, Ezkerraldea Enkarterri Cruces Integrated Health Organisation, Barakaldo, Spain.
Ane FullaondoBiosistemak Institute for Health System Research, Bilbao, Basque Country, Spain.
VOICE study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: 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. Methods: 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. Results: 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€-13,404€. The InIV showed that centre B generated an additional PACELY at 376€ compared to A, reflecting differences in organisational efficiency. The value curve showed variation in efficiency across VBHC thresholds, depending on the healthcare context. Discussion: 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.

Indexed as

Breast NeoplasmsValue-Based Health CareCost-Benefit AnalysisFemaleHumansPatient Reported Outcome MeasuresQuality-Adjusted Life Yearsbreast cancercost-effectivenessefficiencyHEORPACELYQALYvalue-based healthcarevalue equation

Identifiers

PMID42052032
PMCPMC13112487

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Registered trials

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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.