PNS69 Measuring and Valuing Patient Experience

Abstract

Whilst patient experience is often considered an intermediate or process outcome, there is growing evidence that patient experience is of value to patients in and of itself. The aim of this research was to develop a patient reported experience profile measure and classification system amenable for deriving a preference based scoring algorithm across healthcare settings. Initial identification of domains were informed from a systematic literature review and interviews with patients and clinicians. Items were drafted and iteratively developed among an investigative team with fields of expertise in patient experience, psychometrics, and health economics and health services management. An online survey of 2,400 participants with a healthcare experience in the past three months were analysed using psychometric analysis techniques including exploratory factor analysis and Rasch analysis. Think aloud studies were subsequently conducted in 12 patients to identify difficulty in interpretation and understanding. A validation survey of 500 participants with a health care experience within the past three months was subsequently administered. Confirmatory factor analysis and Rasch analysis. A 27-item profile measure comprising of nine domains was identified. Based on triangulation of results from psycometric analyses, patient and clinician feedback, a 10-item, 9 domain classification, the G-9, was determined. Domains of patient experience were: communication, involvement, discomfort, co-ordination, facility, confidence in quality of care, convenience and person centred. There was no evidence of differential item functioning with respect to participants health status, age, sex, education, language, or where the experience took place (emergency department, inpatient, outpatient or community). A generic patient experience classification amenable for use across healthcare settings and patients was developed. This novel development enables the subsequent development of a preference based scoring algorithm. The presentation of comparative experience, along with outcomes and costs will promote decision making that enables patient centred and value based healthcare.