Abstract
BackgroundPatient‐reported outcome measures (PROMs) are increasingly used to establish the value of health care. In order to reflect value, PROMs should measure outcomes that matter to patients. However, patients are not always involved in the development of PROMs. This study therefore aimed to investigate whether PROMs, which were developed without patient involvement, are relevant to patients and whether the level of importance allocated towards aspects of these PROMs varies between patient groups.MethodsAll patients from 20 Dutch hospitals undergoing hip or knee surgery in 2014 were invited to a PROMs survey. Participants were asked to rate the importance of each of the items in the HOOS‐Physical Function Short form or the KOOS‐Physical Function Short form, the EQ‐5D and the NRS pain.ResultsMost outcomes were considered important. However, 77.7% of hip surgery patients rated being able to run as unimportant. Being able to kneel (32.7%) or squat (39.6%) was not important to a considerable minority of knee surgery patients. Pain, especially during rest, was considered very important by both hip (68.2%) and knee (66.5%) surgery patients. Patients who were older, male, experienced overall bad health and psychological health considered many items from the PROMs less important than other patients.DiscussionPatients differ in what they consider important. Health‐care professionals should explore patients’ preferences and discuss which treatment options best fit patients’ preferences. Additionally, if PROMs are used in performance measurement, further research is needed to look at whether and how variation in patient preferences can be taken into account.
Highlights
In several countries such as the United States, the United Kingdom, Sweden and the Netherlands, policymakers try to deal with the ever higher spending on health care for mediocre quality of care
By adding importance ratings to the Patient-reported outcome measures (PROMs), we aimed to investigate the following: 1. What is the level of importance patients allocate towards the different aspects of a few well-known PROMs?
Even though the PROMs included in this study were developed without patient involvement, patients considered most items of the KOOS-PS, HOOS-PS, EQ-5D and NRS pain important
Summary
In several countries such as the United States, the United Kingdom, Sweden and the Netherlands, policymakers try to deal with the ever higher spending on health care for mediocre quality of care They do so by shifting the focus from contracting or paying for health care based on numbers and price towards contracting based on quality.[1,2,3,4,5,6,7,8] The goal is to achieve the highest value, which is the best possible health outcomes per monetary unit spent.[9] Delivering good quality of care and thereby achieving good health is less expensive than having to deal with poor health.[10] a value based health-care system is expected to increase the economic sustainability while benefiting patients, health-care purchasers and health-care providers by improving care.[11] A way to establish value is to measure and compare patient outcomes[12] and weigh these against treatment costs.[5]. Patient-reported outcome measures (PROMs) are increasingly used to establish the value of health care. Especially during rest, was considered very important by both hip (68.2%) and knee (66.5%) surgery patients. If PROMs are used in performance measurement, further research is needed to look at whether and how variation in patient preferences can be taken into account
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