Value-based surgical care: barriers, facilitators and incentives. A meta-ethnographic synthesis

This academic paper examines the transition from traditional fee-for-service models to value-based care (VBC) in surgical settings, highlighting both its potential and its complexity. Based on a meta-ethnographic review of 24 qualitative studies, it demonstrates that while VBC can improve patient outcomes and reduce costs, its adoption remains inconsistent due to financial risks, infrastructure limitations, and resistance to change. The analysis identifies key enablers such as stakeholder alignment, multidisciplinary collaboration, and robust data systems that make outcomes measurable and actionable. At the same time, the shift challenges established clinical practices and incentive structures, requiring not only technical implementation but also deeper cultural and organizational transformation. Ultimately, the paper underscores that achieving value in surgery is a multifaceted process that depends on balancing economic sustainability, clinical effectiveness, and stakeholder engagement.