Project: Integrating the Patient Perspective in the Identification of Low-Value Care to Uncover Gender Disparities in Health Care
Viktoria Steinbeck, MsC, is a 2024–25 German Harkness Fellow in Health Care Policy and Practice. She is currently Research Fellow in the Department of Health Care Management at the Berlin University of Technology, where her research focuses on use of patient-reported outcomes (PROs) in enabling patient-centered health care. Steinbeck has published research papers on different use cases of PROs such as PRO-based remote monitoring, PRO thresholds as clinical support tools, the detection of gender-related health disparities using PROs, and upscaling use of PROs to the health-system level. Her research has been published in research outlets including JAMA Network Open, Value in Health, and others. As co-creator of the first value-based health care course for German-speaking countries, she is engaged in teaching interdisciplinary cohorts about aligning incentives to achieve outcomes that matter to patients.
Previously, Steinbeck gained work experience with a variety of health care stakeholders, including the European Commission, Allianz Insurance Germany and Benelux, and the German Network for Health Services Research, and as an EU policy consultant in Brussels. She earned a double master’s, in health economics and in health policy, innovation and management, at Maastricht and Cologne University.
Project overview: Germany and the United States strive to reform their health care systems along value-based health care principles, including the measurement of PROs and patient-reported experiences (PREs). In the assessment of value provided by the health system overall, however, the patient perspective is not yet widely integrated. Additionally, within various medical domains, research has revealed health differences and biases due to sex and gender in the way patients are diagnosed, treated, and cared for. PROs and PREs are presumed to offer multiple advantages with respect to detecting quality variation overall and gender disparities in particular. Whereas indicators like mortality and readmission rates reflect worst-case scenarios, PROs reflect the wide spectrum of health impacts experienced by patients in their daily lives. Moreover, clinician-reported outcomes could be affected by the same biases that affect existing treatment disparities between genders. The proposed study connects three overarching themes: 1) measuring and reducing quality of care variation; 2) integrating the patient perspective in quality assessments; and 3) identifying gender disparities in health care. In this intersection, the project aims to add value to existing research by uncovering gender disparities in the value of care provided through dedicated indicators that clearly integrate the patient perspective. In phase 1, based on expert interviews and supporting literature, I will define and refine value-of-care indicators best able to uncover inequities. In phase 2, I will apply these indicators through analyses of U.S. and German data to uncover potential gender disparities in the value of care provided.