At the Global Health Delivery Project, we have been promoting the idea of value-based health care delivery. What we mean when we say this is that we think health care delivery systems should be designed to maximize the health outcomes given the dollars invested. In assessing value, we look at the complete cycle of care for a given condition, all the activities involved from prevention to diagnosis to treatment to disease management, in the form of a value chain (see for example the Care Delivery Value Chain applied to HIV/AIDS Care in Resource-Poor Settings here).
By looking at the complete configuration of activities, we believe it is possible to identify gaps in services, services that are important for positive health outcomes, or services that do not contribute significantly to the desired outcome. This recent JAMA article, “Assessing Value in Health Care Programs” confirms these ideas, suggesting that value cannot be judged on a small scale or by looking at returns on investments for a particular service, innovation, or treatment.