175 Patient experiences with VBHC interventions at the HIV outpatient clinic 6 INTRODUCTION The introduction of combination antiretroviral therapy (cART) has transformed HIV into a chronic, lifelong condition with a life expectancy comparable to the general population 1-4. As a result, people living with HIV are aging and are at risk of developing treatment side effects in the long term (for example osteoporosis, renal function loss, lipodystrophy) and comorbidities such as hypertension, diabetes, cardiovascular disease, neuropathy and, liver and kidney disease 1,3,5. Healthcare providers must pay increasing attention to the prevention and treatment of these comorbidities not traditionally associated with HIV. In addition, improving and ensuring a good health-related quality of life among people living with HIV has become more important 2,4. The transformation into a chronic disease has led to a change in the demand for care, corresponding procedures and the way care is delivered to people living with HIV. One way to improve the care provision for people living with HIV is through the implementation of value-based healthcare (VBHC). In theory, VBHC enables healthcare systems to create more value for patients. Here patient value is the measurable improvement in a patient’s health outcome divided by the cost of achieving that improvement 6,7. Through the implementation of VBHC, healthcare systems are thought to improve patient experience and population health, reduce the per capita cost of healthcare, as well as improve healthcare professional experiences 6. In the Netherlands, patient value is not so much perceived as an improvement in a person’s health outcome that come at a certain price, but rather as a result of the interactive patient-healthcare professional relationship which tends to the individual needs of each patient 8. Using this definition of value, it is essential to improve the interaction between patient-healthcare professional during a consultation. The Erasmus Medical Centre (Erasmus MC) in Rotterdam, the Netherlands started to implement VBHC with the implementation of a generic quality of life questionnaire to measure and monitor patient’s health outcomes. In addition, the HIV outpatient clinic tried to increase the value of the patient-healthcare professional interaction during a consultation, by making some changes to the schedule and structure of the consultations. This study aims to explore how patients experience the VBHC intervention as implemented at the HIV outpatient clinic of the Erasmus MC.
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