Model for Value-based Policy-making in Health Systems

Lida Shams, Ali Akbari Sari, Shahram Yazdani, Taha Nasiri


Background: Values are at the heart of discussions related to policy-making and any kind of reforms in health systems. Despite wide recognition of its importance, the concept of value is still vague and the policy-making processes remain astray with respect to values. This study aims to provide a model of value-based policy-making and to explain the concept value and how it affects policy-making.

Methods: The main question of the current study is to explain the concept of value-based policy-making and developing a model, based on the explained concept. In this line, critical review method and Carnwell and Daly approach and using particular keywords related to stewardship, and searching databases were used. In the initial search, 739 studies were obtained, of which using targeted sampling method, 11 studies were finally selected. Then, in order to design and explain different aspects of the value concept in the health system and to develop a model, selected studies were criticized, and finally, the conceptual model of value is designed and explained.

Results: The concept of value and its effects, dimensions and its relation to principles, evidence and criteria were determined at different stages of the policy-making process. It was also revealed that value-based policy-making in a health system is contingent upon the realization of terminal values.

Conclusions: In the process of selecting the best policy option, it is necessary to identify the relationship between terminal, instrumental, criterion, and evidence to avoid deviating from the reference value framework in any country and to avoid blindly imitating other experiences in other countries.


Ethical theory; health policy; reference values; research evidence

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