Exploring the meaning of value-based occupational therapy services from the perspectives of managers, therapists and clients

Introduction

There is a worldwide trend towards value-based health care, which strives to control healthcare costs while maximising value for clients. The main concept of value has been defined as health outcomes achieved per US dollar spent. This research explored how clients of occupational therapy services, managers and occupational therapists perceived value in occupational therapy services.

Method

A qualitative design was used to explore the perspectives of clients (n = 11), occupational therapists (n = 7) and occupational therapy managers (n = 7). Appreciative inquiry guided the two phases of semi-structured interviews (n = 5) and focus groups (n = 6). Inductive and deductive coding were used to establish themes.

Findings

Three themes encompassed the participants’ perceived value of occupational therapy services: (1) outcomes which are meaningful to daily life, (2) a constructive client–therapist relationship and (3) affordable, coordinated and understandable therapy.

Conclusion

Participants attributed value to occupational therapy services when they encountered personalised goal setting, focused on meaningful outcomes, managed personal costs and experienced positive therapeutic relationships. Enhancing services could focus on (1) developing skills in collaborative goal setting, (2) determining suitable outcome measures which are meaningful at personal- and service-level reporting, (3) encouraging self-management strategies, and (4) emphasising therapeutic relationships and supporting therapeutic communication skill development.