“Health outcomes should be the most relevant indicator when carrying out Value-Based Public Procurement in the health sector. However, this is also the most complicated indicator to implement”, this is one of the conclusions of the survey carried out by the Spanish Society of Health Managers (Sedisa), with the collaboration of PRIM, among fifty health managers, of the majority of CC.AA.
The results of this work, which have been presented at the Conference ‘Experiences in value-based public procurement’, organized by Sedisa and PRIM, yield significant results on the indicators to take into account in Value-Based Public Procurement. José Manuel Pérez Gordo, treasurer of Sedisa, explained that “the type of indicator valued as most relevant by the participants to measure Value-Based Public Procurement are health results, indicated by more than 62%. However, 50% also indicate that this is precisely the most difficult criterion to measure.”
The survey also reveals that only 40.43% of the participants affirm that Value-Based Public Procurement is carried out in their organization. Of these, almost 53% affirm that award criteria are included in public contracts linked to the value provided by the product or service, only between 0 and 25%. However, half of the participants believe that this rating should be higher, between 26 and 50%, and 35.71% more participants believe that a percentage score between 51 and 50 should be assigned. 75% in public tenders.
Although participants believe that health outcomes are what should matter the most, those who carry out Value-Based Public Purchasing in their hospital or organization point out that, currently, the most used criteria are those related to efficiency.
Regarding the measures valued as the highest priority to implement indicators and measure the public purchase of indicators, they are “the correct definition of indicators, valued with a 6.67 out of 7, and training on these indicators (6.47 out of 7), followed by the participation of patients in the definition of value (5.8 out of 7)”, explained Pérez Gordo. In conclusion, he pointed out that “the establishment of specific indicators facilitates the development of processes and their measurement and helps healthcare organizations draw up a roadmap for value-based management.”
Pioneering experiences
The results of the survey represent another contribution to the necessary collaboration between all the actors involved, as commented by the other participants in the meeting with the media. As a starting point for this collaboration, Fernando Oliveros, executive advisor of PRIM, has detailed three pioneering and innovative experiences, from three hospitals in Madrid and Barcelona, which are part of what the company calls ‘Comprehensive Advanced Module Management Solutions’ ( SIGMA) and that can be a starting point to establish that necessary collaboration between all the actors involved – public administrations, technology industry, health professionals and patients – with the aim of “improving our health system and helping health organizations to face challenges such as sociodemographic changes, the increase in chronicity and also technological innovation and digitalization,” he noted. Oliveros has concluded that “purchasing for value is the key to efficient and sustainable healthcare in public-private collaboration.”
The first of these experiences, called ‘Cost per procedure at the Vall d’Hebron University Hospital in Barcelona’, presented by María Blanco Campanero, Purchasing Director of the Catalan Health Institute (ICS), is based on a collaboration agreement between PRIM Group and the Vall d’Hebron Hospital. After analyzing the operating room needs, the company provides the hospital, at no initial cost, with the boxes of reusable laparoscopy instruments that are considered necessary.
For its part, the hospital is committed to the consumption of a kit of disposable material for each cholecystectomy performed (estimated 500 / year). With this, it is expected to reduce plastic consumption by 77% and achieve savings of 15% in direct purchases.
The second experience, ‘Practical example of the approach to the diabetic foot at the Puerta de Hierro University Hospital in Madrid’, presented by Almudena Santano Magariño, managing director of the Infanta Cristina University Hospital in Madrid and former Director of Nursing at Puerta de Hierro, is a transversal project that offers a global solution to the approach to this pathology, which is at the origin of 5 out of every 6 amputations that occur in the foot. 40% of diabetic foot injuries can be avoided if they are diagnosed and treated early. For this reason, PRIM offers personalized services and advice (podiatrist consulting, outsourced physiotherapy services, technical and prosthetic aids for amputation cases), in order to improve these figures, both in the area of prevention and treatment.
Finally, the experience ‘Practical example of a new rehabilitation model at the 12 de Octubre University Hospital in Madrid’, presented by Juan Castillo, head of the hospital’s Physical Medicine and Rehabilitation Service, focuses on the contribution of high-tech equipment without initial investment by the hospital, the creation of efficient activity procedures (pathology groupings, telerehabilitation, etc.). All of this shortens therapy times and leads to more effective management.
The objective is the reduction or elimination of waiting lists in the hospital, which can also be considered a measurement indicator under the umbrella of the Value Purchasing concept.
More than fifty attendees participated in the conference in which these experiences were presented, most of them health executives, regional managers and public sector hospital managers and also those responsible for some of the main entities in the sector, such as Marta Villanueva, general director of the IDIS Foundation and Pablo Crespo, general secretary of FENIN.
In short, as Fernando Oliveros explained after detailing these initiatives, “the concept of Value-Based Management is based on an approach that takes into account not only the economic aspects, but also other less tangible aspects, but crucial for health results. , such as improving the quality of life of patients or avoiding indirect costs in public purchases.”