Previously submitted to: JMIR Formative Research (no longer under consideration since Aug 11, 2026)
Date Submitted: Sep 9, 2025
Open Peer Review Period: Sep 10, 2025 - Nov 5, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Identifying the Dimensions of a Value-Based Care Organization in Patients with Breast Cancer: Findings from a Qualitative Study
ABSTRACT
Background:
The rising costs of breast cancer treatment, along with patients’ dissatisfaction regarding quality of care, have become significant challenges for Iran’s health system.
Objective:
This study aimed to identify the key dimensions of value-based care within Iran’s healthcare system and to develop a conceptual model for its implementation in breast cancer patients.
Methods:
This qualitative research was conducted through semi-structured interviews with 20 participants, including physicians, managers, nurses, psychologists, a physiotherapist, and informed patients. Participants were selected by purposive sampling, and interviews continued until theoretical saturation was reached. Data collection and analysis were performed concurrently using open, axial, and selective coding. To ensure the credibility of findings, member checking, participant review, and collaborative analysis were employed.
Results:
Data analysis resulted in the extraction of 739 initial codes, 152 concepts, 25 subcategories, and finally 5 main categories: "Ethical and Professional Standards," "Financial and Managerial Support," "Patient and Family Engagement," "Provision of Appropriate Services and Facilities," and "Quality and Reliability of Services." These categories reflected a wide range of concerns among patients, healthcare providers, and managers, including treatment equity, access to medications, insurance coverage, gender-sensitive care, family involvement, and deployment of skilled personnel.
Conclusions:
The findings suggest that the successful implementation of value-based care in Iran’s health system requires simultaneous attention to cultural, structural, managerial, and human factors. A clear understanding of patient priorities, active stakeholder participation, and the development of supportive and technological infrastructures are essential for effective application of this model in breast cancer care.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.