However, it cannot continue like this for long. European society is aging, the number of patients suffering from multiple chronic diseases simultaneously is increasing, and the shortage of healthcare professionals is becoming critical. Data from the European Union and the Organisation for Economic Co-operation and Development (OECD) show that as early as 2022, the EU was short of about 1.2 million doctors, nurses, and midwives. The demand for help is growing faster than the number of people able to provide that help, so we must change our approach to what truly creates value in medicine, according to a press release from “Health Tech Accelerator.”
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What we measure is what we get: the Lithuanian paradox
For a long time, the efficiency of the health system was measured through the prism of activity volumes: the number of consultations performed, hospitalizations, or occupied beds. However, for a person who has had a hip replacement, it does not matter how many days they spent in the hospital; what matters is whether they will be able to walk and work without pain after a few months. In professional language, this shift from volumes to outcomes is called “Value-Based Healthcare.” According to this model, value is defined as the patient’s health outcomes achieved divided by the care costs over the entire treatment cycle.
The case of Lithuania perfectly illustrates why traditional measurement no longer works. According to infrastructure indicators, we look great: Lithuania has 4.6 practicing doctors per thousand inhabitants (OECD average – 3.9) and 5.5 hospital beds (OECD average – 4.2). However, these numbers do not convert into better health: our expected life expectancy is only 77.6 years, about four years behind the EU average.
Even more telling is the number of avoidable hospitalizations due to conditions that should typically be managed by a family doctor; Lithuania records as many as 815 hospitalizations per one hundred thousand inhabitants (OECD average – only 473). This is a clear signal that the system is fragmented, and the most expensive resources, i.e., medical staff time and inpatient care, are used inefficiently.
Creating value is not just saving
When talking about value-based healthcare, there is often fear in society and even among professionals that it is just a nicer name for budget cuts. This is a mistaken view. If the state reduces expenses but patients’ health worsens, no value is created. Likewise, there is no value when an expensive technology is implemented that does not actually change the patient’s life.
The real truth is that the most expensive thing is poor medical quality. Complications require additional treatment, and duplicated tests occur due to lack of data sharing. When care is fragmented, the patient is forced to wander between specialists, and the system performs unnecessary work. The goal of value-based systems is not to save at the expense of patients but to reduce resource waste.
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Small country advantage: where to start?
Although the challenges are great, Lithuania has a strategic advantage – we are small. We do not need a grand, decades-long national reform to start changes. In a small system, it is much easier to bring doctors, hospital managers, state institutions, and patient organizations to the same table.
One can choose a specific disease (for example, diabetes or heart failure), agree on the most important recovery indicators for the patient, and start measuring them. The transition to value-based healthcare protects public budgets, reduces medical burnout, and helps keep society healthier.
This necessary dialogue is already beginning in Lithuania. The “Health Tech Accelerator” initiative presents a training program dedicated to education about the value-based healthcare system. Because ultimately, there is only one important question for everyone – patients, taxpayers, and medical professionals alike: how to create as much real value as possible for human health with the available human, financial, and time resources?
Free training is already available on the platform:
Health Tech Accelerator training platform
Value-based healthcare training modules are prepared in Lithuanian and English. The training is certified and aimed at improving healthcare professionals’ competencies.
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