The implementation of value-based care in Shuang Ho Hospital

Introduction: The services of value-based care stem from measuring the outcomes of health against the costs incurred,

with the patient's maximum benefit in mind. Communicating with patients to address unnecessary medical practices
allows patients to spend less money while attaining better health. This shifts the traditional healthcare culture, enhancing
the quality of communication and understanding with the public, ultimately providing genuine assistance to the populace.

Methods: Shuang Ho Hospital comprehensively reviews medical treatments and processes, promoting the
implementation of value-based care. This includes strategies such as Shared Decision Making (SDM), choosing wisely,
Enhanced Recovery After Surgery (ERAS), and smart healthcare.

Results: 1.SDM: Developed 64 PDA tools, serving 52,268 individuals. Taking intensive palliative care as an example,
through the introduction of SDM, the acceptance rate of intensive palliative care increased from 70% in 2019 to 90.7% in
2023. Among them, the rates of receiving "palliative care in the intensive care unit" and "withdrawal of life support
equipment to receive palliative care in the ward" reached 83.3%. Patient satisfaction increased from 3.8 points to 4.32
points (out of 5), and satisfaction with "reducing decision conflicts" reached 4.27 points.
2.Choosing Wisely: Implemented 15 initiatives. Taking "Excluding neurological problems in emergency room fainting
patients, avoiding BRAIN CT scans" as an example, advocacy began in August 2019. If emergency room fainting patients
showed no neurological issues, head CT scans were no longer performed. This led to a decrease in the previous head
CT scan execution rate of 49.8% to 2.56% in 2023. The cost for a scan with contrast was 6,000 yuan, while without
contrast was 3,800 yuan. Therefore, each avoided head CT scan saved patients approximately 4,900 yuan, totaling
savings of 2.05 million yuan annually. Each head CT scan results in radiation exposure of approximately 2 millisieverts.
With an average reduction of 35 scans per month, radiation exposure decreased by about 70 millisieverts. This radiation
exposure reduction is equivalent to the exposure from 7,000 chest X-rays.
3.ERAS: Implemented 12 procedures, serving 577 individuals. By integrating SDM with ERAS, forms and structured
medical consultations were developed to enhance teamwork and utilization of medical resources. For TKR surgeries, the
postoperative VAS SCORE decreased from 3.1 to 2.1. Additionally, for THR surgeries, the average length of hospital stay
decreased from 7.5 days to 6.6 days.
4.Smart Healthcare: Promoted intelligent care processes in six areas including outpatient, emergency, inpatient, surgery,
laboratory, and administration. Taking the example of artificial intelligence (AI) prevention and treatment models for heart
failure, electronic alerts and intelligent recognition through wearable devices were utilized. These data were then tracked
on a cloud platform. AI assisted in interpreting risk trend warnings, enabling bidirectional interaction between patients and
healthcare providers to provide medical care. This initiative not only reduced the mortality rate from falls by 12.33% but
also decreased healthcare costs by 3,000 yuan per person per year.

Conclusion: Our hospital's promotion of value-based care focuses on strengthening patient communication. This not only
helps patients gain a deeper understanding of their symptoms and treatments but also facilitates faster recovery from
illness or injury. Additionally, it can reduce unnecessary expenses, enhance the efficiency of healthcare professionals'
treatment, and improve patient satisfaction.