PhD Defence Lotte Bock

Keywords: Value-based healthcare, Postgraduate medical education, Medical residents, Decision-making 
 

"Exploring value-based healthcare decision making in postgraduate medical education A focus on medical residents’ perspectives"

Healthcare costs in the Netherlands continue to rise at a rapid pace, posing challenges for the sustainability of the healthcare sector. To address this issue, it is essential to reduce low-value care while simultaneously maximizing patient value and controlling costs. Value-based healthcare (VBHC) has emerged as a promising approach to achieve these goals. This dissertation investigates how medical residents make VBHC-related decisions in the clinical setting and explores ways to enhance their training in delivering VBHC. First, it clarifies the terminology related to VBHC to enhance an understanding. Second, it evaluates the cost-effectiveness of existing studies on endovascular treatment and neurosurgical clipping for aneurysmal subarachnoid hemorrhage. Third, it examines how VBHC can be strengthened using the Positive Health dialogue tool. Fourth, it investigates sociocultural influences on decision-making. Finally, it explores contextual factors that affect decision-making processes. These insights contribute to improving the medical education of residents in delivering more value-driven healthcare. 

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