Abstract
This study aimed to develop a conceptual and practical framework for prioritizing research agendas on Value-Based Health Care (VBHC) in Thailand. It was motivated by the observation that, although VBHC has gained increasing attention in recent years, its meaning, scope, and policy Implications remain inconsistently understood across Thai stakeholders. As a result, many initiatives labeled as "value-based" still focus narrowly on efficiency improvement or cost containment, rather than on comprehensive health system redesign centered on outcomes that matter to patients. The academic committee discussions reviewed in this study similarly emphasized that the key challenge in Thailand is not a lack of isolated activities, but a lack of shared conceptual clarity and system-level alignment. The study synthesized evidence from three components: a review of international literature and experiences, qualitative analysis of expert and stakeholder deliberations in the Thai context, and the development of criteria for prioritizing research topics that are genuinely aligned with VBHC principles. The literature review showed that successful VBHC reforms do not arise from single instruments alone. Rather, they depend on integrated care across the patient journey, systematic measurement of outcomes and costs over the full cycle of care, and payment mechanisms that reward collaboration and value rather than fragmented. activity-based delivery. The qualitative findings reinforced this conclusion and highlighted five major themes: the need for a shared operational understanding of VBHC in Thailand; the centrality of integrated care across the full patient journey; the importance of developing outcome measurement and payment reform together; the value of starting with high-readiness tracer conditions or services; and the need to explicitly incorporate quality, efficiency. equity into the Thai VBHC agenda. Based on this synthesis, the study proposes a prioritization framework for VBHC research in Thailand. High-priority topics should demonstrate clear alignment with VBHC principles, potential to improve outcomes and experiences that matter to patients, relevance to major system bottlenecks, and the ability to inform future development of data systems, integrated care models, and value-based payment mechanisms. In this sense, the framework helps distinguish between projects that are broadly useful for health system improvement and those that are truly strategic for advancing VBHC in the Thai context. In conclusion, the study argues that Thailand's VBHC research agenda should move beyond fragmented issue-based studies toward a sequenced strategy for health system transformation. This means building shared conceptual clarity, supporting pilot work in feasible and policy-relevant areas, developing outcome and cost measurement systems suited to the Thai context, and progressively linking research findings to payment reform and broader policy redesign. If pursued systematically, this approach can help Thailand move VBHC from a broad aspiration to an actionable reform pathway that improves value, quality, and equity across the health system.
