“Value-Based Healthcare in Palestine: Strategic Assessment, Challenges and Recommendations” رسالة دكتوراة

Abstract

Background: This study aims to evaluate the implementation of Value-Based Healthcare (VBHC) in Meso-level hospitals in Palestine, focusing on its potential to improve patient outcomes while optimizing healthcare costs. VBHC emphasizes integrated care, outcome measurement, and patient-centered approaches, making it particularly relevant in addressing the unique challenges of the Palestinian healthcare system, which is marked by political instability, resource constraints, and fragmented governance. Methodology: A mixed-methods approach was employed, combining quantitative surveys and qualitative interviews with healthcare professionals and policymakers. The collected data were analyzed to assess the extent of VBHC adoption. The study focused on six key VBHC components: Integrated Practice Units (IPUs), outcome and cost tracking, bundled payment models, multi-site integration, geographic expansion, and IT platform utilization. Result: The study reveals significant deficiencies in implementing Value-Based Healthcare (VBHC) in Palestinian hospitals, with a low overall mean score of 2.46. All VBHC constructs scored poorly (2.12–2.8), highlighting inadequate governance frameworks, insufficient IT infrastructure, and cultural resistance as major barriers. While some progress has been made in tracking outcomes and cost efficiency, the lack of integrated care delivery systems and bundled payment mechanisms hinders full adoption. Regional disparities in healthcare quality and access further complicate VBHC integration. Recommendations include enhancing governance, fostering collaboration, and investing in IT infrastructure to support data transparency and tailored reforms for Palestine. Conclusion: This research demonstrates the potential of VBHC to transform healthcare delivery in Palestine by addressing inefficiencies and improving patient-centered outcomes. However, realizing this potential requires overcoming systemic, cultural, and infrastructural challenges. The study's recommendations provide actionable insights for policymakers and healthcare providers, contributing to a global discourse on the feasibility of VBHC in conflict affected and resource-limited settings.