Introduction
Medical companies are faced with delivering value, while the latter is defined as the ratio of quality, quality to cost. For this mission to be achieved, it is necessary to reduce the cost of treatment, improve its quality and ensure wider access of the population to it (Burns et al., 2012). At the same time, the question of how feasible is the achievement of all three goals remains relevant and unresolved. For example, increasing people’s access to health services may be associated with higher costs. At the same time, it is not only American healthcare organizations that strive to fulfill this mission; this problem is of a global nature (Burns et al., 2012). Value-based care is a medical practice that combines the value of the best scientific evidence and individual values for the patient. To confidently say that any medical intervention leads to a good result, it is necessary to assess this result correctly and, even better, to measure it quantitatively.
Institutional Theory
Maintaining an improvement in human health throughout the history of society is one of the most critical problems and tasks of its functioning. The degree of development of health care, the quality, availability, and timeliness of medical care for the population is reflected not only in the indicators of public and individual health of people. These factors also demonstrate the quality of life and well-being of the community. It should be borne in mind that medical systems generate value by producing healthy and non-health gains that promote well-being (Burns et al., 2012). Health care is in the stage of active institutional transformations, which is to qualitatively improve the efficiency and accessibility of the medical care system. This is reflected in the development of human resources at all levels of the industry and high-tech medical services for the population. However, efforts to enhance quality may not always positively change the health state of patients. Therefore, it is necessary to introduce measurable indicators by which medical organizations can judge whether the changes contribute to improving patients’ health.
General beliefs about justice and society’s requirements for their formation are among the features of economic institutions in health care. The ideas about what kind of health care is socially fair are not universal and diverse in different countries and among social groups. Modern society should provide each of its members with the opportunity to receive a minimum of medical care, regardless of their social status and income. This is the only judgment that no one wants to argue with. The institutional environment and its limiting framework form the economic mechanism of health care (Porter, 2010). It shapes the self-regulation mechanism that maintains the system’s equilibrium around specified macroeconomic parameters (Dixit and Sambasivan, 2020). On the other hand, healthcare can also be viewed as an institution, which is a combined set of ideas, rules, and mechanisms aimed at providing medical care to the population (Burns et al., 2012). Thus, the focus of a value-based health system is on human health.
Institutionalization can be viewed as a process of harmonized, conceptual, legal, technological, and other systemic transformations in the healthcare sector. Any changes to the system are inevitably associated with specific costs for changing it. Therefore, it is necessary to search for a rational transition from the existing system to a more promising one. Institutional changes should only be implemented if it is objectively clear that they will lead to value creation.
System Perspective
Medical organizations are components of the health care system, i.e., its subsystems. Moreover, they have all the qualities inherent in the elements of the system and, in turn, are systems themselves. Structural orientation presupposes the portrayal of a medical organization as a holistic entity, consisting of interacting parts, each of which contributes to the characteristics of the whole (Dixit and Sambasivan, 2020). Given that technical and human factors strongly influence the activities of medical organizations, they can be attributed to socio-technical systems. Health systems of all types strive to create as much value as possible using their free resources.
Representing a medical organization as a complex system in healthcare allows a deeper understanding of many aspects of its functioning in the market. It also helps in identifying many key points affecting financial and economic activities. This makes it possible to consider many problems from different angles, i.e., comprehensively, which helps to optimize the management process (Burns et al., 2012). The success or failure of healthcare institutions in the medical market largely depends on the business entities themselves. Only when all factors are taken into account and the perception of the medical organization as a system will it be possible to create value and provide patients with value-based care.
To ensure its long-term existence, the organization must have feedback (information about uncontrollable factors, the institution’s activities, the effectiveness of the marketing plan). To that end, one should systematically assess the degree of patient satisfaction, monitor the state of the economy, anticipate a possible shortage of resources, and study independent media. Perception of medical organizations as systems will allow treating the process of value formation as an activity associated with the transformation of all elements (Porter, 2010). Thus, marketing management should be based on a systematic approach, since only in the interconnection of the top marketing points can an organization succeed in the medical services market.
Organizational Ecology
Organizational ecology emerged as a particular trend in the American sociology of organizations in polemics with supporters of rationalist concepts. The latter viewed the development of the organization as entirely conditioned by the conscious activity of the manager. Organizational ecology is understood as a historical-systems approach within the objectivist direction of macro-sociological theory. Within this theory, organizational development is defined as a process associated with expanding the set of socio-cultural patterns of behavior and activity. According to the analyzed concept, an organization cannot carry out activities and survive outside of interaction with other institutions and communities. This is explained by the fact that they perform similar activities and compete for resource-ecological niches. Organizational ecology emphasizes the extent to which organizations are involved in resource sharing and transformation. In the context of this theory, which focuses on the population, healthcare providers should be held accountable for the growing importance of value in health care.
Conclusion
The value should be assessed in terms of the results achieved and not depending on how large the volume of services provided is. These results are multidimensional and depend on many varied factors. Therefore, the value should be assessed from a systemic perspective. That is, by evaluating how the elements interact with each other. Patient populations are a crucial component of organizational ecology, and therefore the health of all patient populations should be a priority for healthcare organizations. Finally, for a variety of healthcare settings, outcome measurement should be a critical internal strategy. Prioritizing value improvement in health care delivery should be the mission of a healthcare organization. Otherwise, there is a risk of waste of funds, less innovation, and a general deterioration in the quality of care.
References
Burns, L. R., Bradley, E. H., Weiner, B. J., & Shortell, S. M. (2012). Shortell and Kaluzny’s health care management: Organization, design, and behavior. Delmar Cengage Learning.
Dixit, S. K., & Sambasivan, M. (2020). An integrated multitheoretical perspective of public healthcare Services delivery organizations. Public Organization Review, 20, 319–335.
Porter M. E. (2010). What is value in health care? The New England Journal of Medicine, 363(26), 2477–2481.