Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System

Autores
Roberti, Javier Eugenio; Teijeiro, María Eugenia; Fernández Pazos, Alfonso; Saenz, Victoria; Garcia Elorrio, Ezequiel
Año de publicación
2025
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
BackgroundHealthcare spending in Argentina has risen significantly, yet the system remains inefficient, fragmented, and inequitable, leading to poor outcomes and resource waste. Stakeholders often have conflicting priorities, further complicating quality and sustainability. The study aimed to identify recommendations to advance the implementation of a Value-Based Healthcare (VBHC) model in the Argentine health system.MethodsA modified RAND/UCLA Delphi consensus process was conducted, involving three rounds of expert consultation. The study was conducted within the Argentine health system, involving experts from various levels of care (primary, secondary, and tertiary) and sectors (public, private, and academic). The geographical focus was Argentina, a middle-income country with a fragmented health system. The Delphi panel comprised 21 health sector experts who completed three consultation rounds (two online and one in-person). Evaluation criteria for each recommendation included impact, resources, feasibility, acceptability, and measurability. Agreement among experts was also evaluated. The two parameters categorised recommendations as appropriate, uncertain, or inappropriate. Exploratory follow-up in-depth interviews were carried out to contextualise the findings.ResultsTwenty-one experts participated. Seven recommendations scored highest in the impact criterion, indicating their potential to advance VBHC. These recommendations faced low feasibility and acceptability scores, reflecting systemic unpreparedness. No specific recommendation achieved agreement on all criteria with an overall median score above 7, ie, appropriate. Follow-up interviews highlighted barriers such as policy constraints, system fragmentation, political and economic instability, and concerns about sustainability.ConclusionsThe study underscores the significant interest in transforming the Argentine health system towards VBHC but reveals substantial systemic and structural barriers. The findings highlight the need for further research, dialogue, and collaboration to address feasibility and acceptability challenges. Future studies should explore strategies to overcome policy and structural barriers and the role of political and economic stability in enabling VBHC implementation.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Teijeiro, María Eugenia. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Fernández Pazos, Alfonso. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Saenz, Victoria. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Garcia Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Materia
DELPHI
VALUE-BASED HEALTHCARE
ARGENTINA
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/291255
Acceder
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network_name_str CONICET Digital (CONICET)
spelling Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health SystemRoberti, Javier EugenioTeijeiro, María EugeniaFernández Pazos, AlfonsoSaenz, VictoriaGarcia Elorrio, EzequielDELPHIVALUE-BASED HEALTHCAREARGENTINAhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3BackgroundHealthcare spending in Argentina has risen significantly, yet the system remains inefficient, fragmented, and inequitable, leading to poor outcomes and resource waste. Stakeholders often have conflicting priorities, further complicating quality and sustainability. The study aimed to identify recommendations to advance the implementation of a Value-Based Healthcare (VBHC) model in the Argentine health system.MethodsA modified RAND/UCLA Delphi consensus process was conducted, involving three rounds of expert consultation. The study was conducted within the Argentine health system, involving experts from various levels of care (primary, secondary, and tertiary) and sectors (public, private, and academic). The geographical focus was Argentina, a middle-income country with a fragmented health system. The Delphi panel comprised 21 health sector experts who completed three consultation rounds (two online and one in-person). Evaluation criteria for each recommendation included impact, resources, feasibility, acceptability, and measurability. Agreement among experts was also evaluated. The two parameters categorised recommendations as appropriate, uncertain, or inappropriate. Exploratory follow-up in-depth interviews were carried out to contextualise the findings.ResultsTwenty-one experts participated. Seven recommendations scored highest in the impact criterion, indicating their potential to advance VBHC. These recommendations faced low feasibility and acceptability scores, reflecting systemic unpreparedness. No specific recommendation achieved agreement on all criteria with an overall median score above 7, ie, appropriate. Follow-up interviews highlighted barriers such as policy constraints, system fragmentation, political and economic instability, and concerns about sustainability.ConclusionsThe study underscores the significant interest in transforming the Argentine health system towards VBHC but reveals substantial systemic and structural barriers. The findings highlight the need for further research, dialogue, and collaboration to address feasibility and acceptability challenges. Future studies should explore strategies to overcome policy and structural barriers and the role of political and economic stability in enabling VBHC implementation.Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Teijeiro, María Eugenia. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Fernández Pazos, Alfonso. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Saenz, Victoria. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Garcia Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaOxford University Press2025-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/291255Roberti, Javier Eugenio; Teijeiro, María Eugenia; Fernández Pazos, Alfonso; Saenz, Victoria; Garcia Elorrio, Ezequiel; Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System; Oxford University Press; IJQHC Communications; 5; 2; 9-2025; 1-82634-5293CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/ijcoms/advance-article/doi/10.1093/ijcoms/lyaf013/8259619info:eu-repo/semantics/altIdentifier/doi/10.1093/ijcoms/lyaf013info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-08-25T14:51:46Zoai:ri.conicet.gov.ar:11336/291255instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-08-25 14:51:46.388CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System
title Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System
spellingShingle Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System
Roberti, Javier Eugenio
DELPHI
VALUE-BASED HEALTHCARE
ARGENTINA
title_short Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System
title_full Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System
title_fullStr Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System
title_full_unstemmed Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System
title_sort Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System
dc.creator.none.fl_str_mv Roberti, Javier Eugenio
Teijeiro, María Eugenia
Fernández Pazos, Alfonso
Saenz, Victoria
Garcia Elorrio, Ezequiel
author Roberti, Javier Eugenio
author_facet Roberti, Javier Eugenio
Teijeiro, María Eugenia
Fernández Pazos, Alfonso
Saenz, Victoria
Garcia Elorrio, Ezequiel
author_role author
author2 Teijeiro, María Eugenia
Fernández Pazos, Alfonso
Saenz, Victoria
Garcia Elorrio, Ezequiel
author2_role author
author
author
author
dc.subject.none.fl_str_mv DELPHI
VALUE-BASED HEALTHCARE
ARGENTINA
topic DELPHI
VALUE-BASED HEALTHCARE
ARGENTINA
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv BackgroundHealthcare spending in Argentina has risen significantly, yet the system remains inefficient, fragmented, and inequitable, leading to poor outcomes and resource waste. Stakeholders often have conflicting priorities, further complicating quality and sustainability. The study aimed to identify recommendations to advance the implementation of a Value-Based Healthcare (VBHC) model in the Argentine health system.MethodsA modified RAND/UCLA Delphi consensus process was conducted, involving three rounds of expert consultation. The study was conducted within the Argentine health system, involving experts from various levels of care (primary, secondary, and tertiary) and sectors (public, private, and academic). The geographical focus was Argentina, a middle-income country with a fragmented health system. The Delphi panel comprised 21 health sector experts who completed three consultation rounds (two online and one in-person). Evaluation criteria for each recommendation included impact, resources, feasibility, acceptability, and measurability. Agreement among experts was also evaluated. The two parameters categorised recommendations as appropriate, uncertain, or inappropriate. Exploratory follow-up in-depth interviews were carried out to contextualise the findings.ResultsTwenty-one experts participated. Seven recommendations scored highest in the impact criterion, indicating their potential to advance VBHC. These recommendations faced low feasibility and acceptability scores, reflecting systemic unpreparedness. No specific recommendation achieved agreement on all criteria with an overall median score above 7, ie, appropriate. Follow-up interviews highlighted barriers such as policy constraints, system fragmentation, political and economic instability, and concerns about sustainability.ConclusionsThe study underscores the significant interest in transforming the Argentine health system towards VBHC but reveals substantial systemic and structural barriers. The findings highlight the need for further research, dialogue, and collaboration to address feasibility and acceptability challenges. Future studies should explore strategies to overcome policy and structural barriers and the role of political and economic stability in enabling VBHC implementation.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Teijeiro, María Eugenia. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Fernández Pazos, Alfonso. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Saenz, Victoria. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Garcia Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
description BackgroundHealthcare spending in Argentina has risen significantly, yet the system remains inefficient, fragmented, and inequitable, leading to poor outcomes and resource waste. Stakeholders often have conflicting priorities, further complicating quality and sustainability. The study aimed to identify recommendations to advance the implementation of a Value-Based Healthcare (VBHC) model in the Argentine health system.MethodsA modified RAND/UCLA Delphi consensus process was conducted, involving three rounds of expert consultation. The study was conducted within the Argentine health system, involving experts from various levels of care (primary, secondary, and tertiary) and sectors (public, private, and academic). The geographical focus was Argentina, a middle-income country with a fragmented health system. The Delphi panel comprised 21 health sector experts who completed three consultation rounds (two online and one in-person). Evaluation criteria for each recommendation included impact, resources, feasibility, acceptability, and measurability. Agreement among experts was also evaluated. The two parameters categorised recommendations as appropriate, uncertain, or inappropriate. Exploratory follow-up in-depth interviews were carried out to contextualise the findings.ResultsTwenty-one experts participated. Seven recommendations scored highest in the impact criterion, indicating their potential to advance VBHC. These recommendations faced low feasibility and acceptability scores, reflecting systemic unpreparedness. No specific recommendation achieved agreement on all criteria with an overall median score above 7, ie, appropriate. Follow-up interviews highlighted barriers such as policy constraints, system fragmentation, political and economic instability, and concerns about sustainability.ConclusionsThe study underscores the significant interest in transforming the Argentine health system towards VBHC but reveals substantial systemic and structural barriers. The findings highlight the need for further research, dialogue, and collaboration to address feasibility and acceptability challenges. Future studies should explore strategies to overcome policy and structural barriers and the role of political and economic stability in enabling VBHC implementation.
publishDate 2025
dc.date.none.fl_str_mv 2025-09
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/291255
Roberti, Javier Eugenio; Teijeiro, María Eugenia; Fernández Pazos, Alfonso; Saenz, Victoria; Garcia Elorrio, Ezequiel; Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System; Oxford University Press; IJQHC Communications; 5; 2; 9-2025; 1-8
2634-5293
CONICET Digital
CONICET
url http://hdl.handle.net/11336/291255
identifier_str_mv Roberti, Javier Eugenio; Teijeiro, María Eugenia; Fernández Pazos, Alfonso; Saenz, Victoria; Garcia Elorrio, Ezequiel; Modified Rand/UCLA Delphi Consensus of Recommendations to Advance Towards a Value-based Healthcare Model for the Argentine Health System; Oxford University Press; IJQHC Communications; 5; 2; 9-2025; 1-8
2634-5293
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/ijcoms/advance-article/doi/10.1093/ijcoms/lyaf013/8259619
info:eu-repo/semantics/altIdentifier/doi/10.1093/ijcoms/lyaf013
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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