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On 5 March at 13:00, there will be a 2nd year PhD presentation by Kristoffer Dahl Møberg entitled:

Value-based health care in a Danish context - an analysis of its application on hospital department level

Supervisors: Margit Malmmose & Morten Jakobsen
Discussants: Marija Banovic & Jakob Lauring  

Abstract
This study investigates the application of a newly established value-based agenda in a regional area of Denmark with five hospital units. More specifically, the focus is on the management transition from a productivity emphasis to the integration of a patient oriented quality focus in the local governance model. We seek to further the research agenda of the role of accounting in developing a quality management control focus in hospitals and understand its possibilities and limitations in this avenue. In doing so, we focus on the process of integrating quality both on strategic as well as operational level in a newly established local value-based agenda initiative. Thus, we will examine the translation of the value-based agenda into specific strategic formulations and performance measures on regional, hospital and department level. We will further identify conceptualization, highlighted needs, processes and challenges, and the differences of these on the three levels where we seek to answer the following research questions:   How is the value-based agenda operationalized at hospital department level? We have used both primary and secondary data to examine the governance model of the two hospitals in the CRD. The primary data was collected through 14 semi-structured interviews with key informants. The secondary data consists of annual reports from the region and the hospitals. In addition, it includes reports on the national quality program and on the implementation of the value-based agenda. 

Initially, we find that the financial allocation procedures and framework support a decentralized decision-making process with the freedom to achieve individualized performance measures at department level. Thus, from this perspective the financial structure supports strategic management. However, we also find that the budgets are based on unidentified and unknown historical cost ceilings, which witness a lack transparency and particularly a cost registration system, which does not support patient flow costing information which is a prerequisite for value-based management. Thus, while we identify a willingness and ambition to work with patient perspective management, both the prospective budgets and the cost registration systems hinder a successful integration.