Localizar e intervir: Para uma etnografia das capacidades críticas no processo de implementação do modelo de cuidados de saúde baseados em valor

The value-based healthcare model (VBHC) is an instrument that promises to bring efficiency to the national public health system and its long-awaited sustainability. The model redraws the whole logic of the system's oper-ation, and proposes, as a central aspect, that budgets be channelled to the institutions that produce the most value for the patient. For this purpose, value is understood as the relationship between the quality of care received by the patient and the money spent by him to benefit from care.
In this paper I approach the VBHC model implementation starting from the argument that model designers built this model keeping in mind the conceptualization of “value” with a meaning that is easier to understand from economists' and formal stakeholders' perspective than from patients’, having operated a separation of meaning that is characteristic of the discursive purification process of modern science.
The article ends with the proposal to carry out an ethnography of critical capacities during the process of imple-mentation of the value-based healthcare model in Portugal that may help to bring together the senses of the value that stakeholders attribute to healthcare.