Abstract
BACKGROUND: Escalating healthcare expenditures pose a significant challenge to global fiscal sustainability. Value-based healthcare offers a strategy to improve health outcomes while controlling costs. This study examines the fiscal impacts of value-based healthcare in OECD countries, providing evidence of its role in enhancing fiscal efficiency. METHODS: This study employs three key approaches. A value-based healthcare index was constructed using the entropy weight method to measure performance across 32 OECD countries from 2000 to 2019. Econometric analysis using panel data models explored the fiscal effects of value-based healthcare. Contextual examination further assessed the interactions between value-based healthcare and factors such as government health expenditure, population aging, and elderly disease burden. RESULTS: The results show that higher value-based healthcare performance improves budget balance, reduces debt burden, and enhances fiscal sustainability. Interaction effects highlight the importance of government health expenditure and demographic factors in influencing fiscal outcomes. CONCLUSION: This study demonstrates the fiscal benefits of value-based healthcare, emphasizing its potential to address healthcare inefficiencies and promote sustainable public finances. Policymakers should integrate value-based healthcare principles into healthcare systems while considering country-specific contexts to maximize long-term impact.