Modified Rand/UCLA Delphi consensus of recommendations to advance towards a value-based healthcare model for the Argentine health system (ORIGINAL ARTICLE)
Dublin Core
Title
Modified Rand/UCLA Delphi consensus of recommendations to advance towards a value-based healthcare model for the Argentine health system (ORIGINAL ARTICLE)
Subject
Delphi, value-based healthcare, Argentina
Description
Background: Healthcare 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.
Methods: A 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 categorized recommendations as appropriate, uncertain, or inappropriate. Exploratory follow-up in-depth interviews were carried out
to contextualize the findings.
Results: Twenty-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, i.e. appropriate. Follow-up interviews highlighted barriers such as policy
constraints, system fragmentation, political and economic instability, and concerns about sustainability.
Conclusion: The 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.
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.
Methods: A 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 categorized recommendations as appropriate, uncertain, or inappropriate. Exploratory follow-up in-depth interviews were carried out
to contextualize the findings.
Results: Twenty-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, i.e. appropriate. Follow-up interviews highlighted barriers such as policy
constraints, system fragmentation, political and economic instability, and concerns about sustainability.
Conclusion: The 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.
Creator
Javier Roberti , María EugeniaTeijeiro, Alfonso Fernández-Pazos, Victoria Saenz, Ezequiel García-Elorrio
Source
DOI:https://doi.org/10.1093/ijcoms/lyaf013
Publisher
Oxford University Press
Date
20 September 2025
Contributor
Sri Wahyuni
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Javier Roberti , María EugeniaTeijeiro, Alfonso Fernández-Pazos, Victoria Saenz, Ezequiel García-Elorrio, “Modified Rand/UCLA Delphi consensus of recommendations to advance towards a value-based healthcare model for the Argentine health system (ORIGINAL ARTICLE),” Repository Horizon University Indonesia, accessed February 21, 2026, https://repository.horizon.ac.id/items/show/11305.