2.1 Healthcare delivery and value-based healthcare

Having a variety of healthcare delivery models is crucial for cost-effectiveness, improved quality of care, increased accessibility, promoting preventative care, tailored services and increased resilience. Below are examples of each these aspects (Shrank et al., 2021).

Failure of care delivery in the US was estimated to amount to almost US$165.7 billion in 2019, according to a study by Shrank et al. (2021). The main components that contribute to this waste include clinician and hospital-related inefficiencies such as variability of provision of care by clinicians, and practice and system-based inefficiencies such as superfluous testing, medical errors, adverse events and lack of embracing prevention care practices (Shrank et al., 2021).

Healthcare delivery models are important because of the increasing demands of our ageing population and the high prevalence of chronic diseases creating increased pressure for hospitals and governments. These mounting challenges, including the increasing cost of care, have resulted in innovative ways to roll out a variety of healthcare models. For example, the COVID-19 pandemic resulted in increasing adoption of telemedicine and other virtual care modalities (Smith et al., 2020). An umbrella review examining the benefits of a variety of models of care highlighted some alternative models of care and their efficacy on patient outcomes. The authors found that while there was sufficient evidence to demonstrate comparable or improved care compared to usual care in the new models, factors such as local infrastructure, the health system context and patients’ characteristics are important in determining the suitability of these models for the future (Roberts et al., 2023).

Variety of models

The variety of healthcare delivery models is crucial to enable accessibility for diverse populations and geographic areas. For instance, rural areas might benefit from telehealth services, while urban centres might have more specialised clinics. This variety ensures that healthcare services are accessible to a broader range of people. A review by Bradford et al. (2016) of models of care found that telehealth services have the potential to scale and replicate successful services to reach a wider spread of populations particularly in rural and remote areas. There are several factors that are essential to successful delivery of these models, including concept, ownership, flexibility, finances, proficiency and tools (Bradford et al., 2016).

Different healthcare delivery models emphasise various aspects of healthcare, including preventive care and health promotion. Community-based clinics, for instance, often focus on preventive measures and education to improve overall community health. For example, maternal and child healthcare clinics focus on many aspects of child wellbeing and development. Many clinics have had positive impacts on monitoring children’s early development and increasing mothers’ knowledge (Vyas et al., 2024). A recent study by Mehrin et al. (2022) found that group-based parenting interventions at primary healthcare clinics had a significant positive impact on almost 91 per cent of the children in the intervention, compared with control. There were significant benefits for children’s cognition, language, motor development and overall behaviours (Graif et al., 2021; Mehrin et al., 2022).

Patient needs

Not all patients have the same healthcare needs. By offering a variety of delivery models, healthcare systems can better tailor services to meet the specific needs of different populations, including the elderly, children, individuals with chronic condition and those requiring specialised care (Minvielle et al., 2021). This approach aligns with the principles of value-based healthcare, which emphasise the importance of customising care to enhance patient outcomes and efficiency. Healthcare customisation or patient-centred care has been the focus of many studies, due to its positive impact on patient outcomes. A scoping review by Minvielle et al. (2021) showed that the customisation of healthcare delivery models not only added value to patients but also contributed to positive patient experiences, reduced costs and improved quality of care and quality of life. This evidence emphasises the importance of value-based healthcare in creating flexible and responsive systems that deliver high-value, personalised care.

System resilience

Healthcare systems with diverse delivery models are more resilient to external shocks and challenges, which aligns with the principles of value-based healthcare. Value-based healthcare emphasises improving patient outcomes and ensuring efficient use of resources. For example, during the COVID-19 pandemic, telehealth and mobile clinics provided essential services when traditional healthcare facilities were overwhelmed or inaccessible. Filip et al. (2022) detailed the expansion of mobile health applications to ensure patients received appropriate care during emergencies. This development resulted in many digital applications that allowed healthcare providers and patients to communicate and manage treatment without risking their lives. Such adaptive approaches enhance the resilience of healthcare systems, ensuring that care remains patient-centred and outcome-focused, even in times of crisis. This underscores the importance of value-based healthcare in maintaining high-quality care delivery amid disruptions.

This following video discusses the importance of innovative healthcare models.