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Creating patient value in glaucoma care: applying quality costing and care delivery value chain approaches: A five‐year case study in the Rotterdam Eye Hospital

Dirk F. de Korne (Research Fellow, Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands and Rotterdam Eye Hospital, Rotterdam, The Netherlands)
Kees (J.C.A.) Sol (Chief Financial Officer, Rotterdam Eye Hospital, Rotterdam, The Netherlands)
Thomas Custers (Researcher, Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands)
Esther van Sprundel (Research Fellow, Rotterdam Eye Hospital, Rotterdam, The Netherlands)
B. Martin van Ineveld (Associate Professor, Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands)
Hans G. Lemij (Opthalmologist, Rotterdam Eye Hospital, The Netherlands and School of Public Health, Catholic University, Leuven, Belgium)
Niek S. Klazinga (Professor of Social Medicine, Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 1 May 2009

2475

Abstract

Purpose

The purpose of this paper is to explore in a specific hospital care process the applicability in practice of the theories of quality costing and value chains.

Design/methodology/approach

In a retrospective case study an in‐depth evaluation of the use of a quality cost model (QCM) and the applicability of Porter's care delivery value chain (CDVC) was performed in a specific care process: glaucoma care over the period 2001 to 2006 in the Rotterdam Eye Hospital in The Netherlands.

Findings

The case study shows a reduction of costs per product by increasing the number of outpatient visits and surgery combined with a higher patient satisfaction. Reduction of costs of non‐compliance by using the QCM is small, due to the absence of (external) financial incentives for both the hospital and individual physicians. For CDVC to be supportive to an integrated quality and cost management the notion “patient value” needs far more specification as mutually agreed on by the stakeholders involved and related reimbursement needs to depend on realised outcomes.

Research limitations/implications

The case study just focused on one specific care process in one hospital. To determine effects in other areas of health care, it is important to study the use and applicability of the QCM and the CDVC in other care processes and settings.

Originality/value

QCM and a CDVC can be useful tools for hospital management to manage the outcomes on both quality and costs, but impact is dependent on the incentives in the context of the existing organisational and reimbursement system and asks for an agreed on operationalisation among the various stakeholders of the notion of patient value.

Keywords

Citation

de Korne, D.F., Sol, K.(J).C.A.)., Custers, T., van Sprundel, E., van Ineveld, B.M., Lemij, H.G. and Klazinga, N.S. (2009), "Creating patient value in glaucoma care: applying quality costing and care delivery value chain approaches: A five‐year case study in the Rotterdam Eye Hospital", International Journal of Health Care Quality Assurance, Vol. 22 No. 3, pp. 232-251. https://doi.org/10.1108/09526860910953511

Publisher

:

Emerald Group Publishing Limited

Copyright © 2009, Emerald Group Publishing Limited

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