Challenges and Prospects ofValue-Based Healthcare in Brazil

Abstract

This paper aims to conduct a systematic literature review (SLR) on value-based health care (VBHC) in Brazil, providing an overview of the state-of-the-art practice of an emerging and strategic topic for the country’s health system. The SLR involved analyzing academic literature (AL) and gray literature (GL) in separate and parallel analyses to answer seven research questions. The results show that Brazil’s VBHC theme has evolved from a theoretical and practical perspective in recent years. However, the topic still needs more consensus, which makes it difficult to share best practices or compare health organizations. The practical initiatives on the subject are punctual and partial and show, in most cases, an attempt to measure results and care costs with an emphasis on economic aspects. The findings also showed the challenges for the Brazilian health system in modifying its structure to correct the flaws that prevent the delivery of value-based health care. This study makes three central contributions to the literature: (i) it shows the scenario of VBHC initiatives in Brazil; (ii) validates the use of GL in SLR for the health area, and (iii) links the state of the art and practice, bringing academia closer to health institutions with theoretical, practical, and managerial implications for VBHC initiatives in the country. This paper presents the current status of the VBHC reality in the country and the challenges to be faced so that the Brazilian health system can seek the required transformation and anticipate its future needs.