Abstract
PurposeWe examined the association between sociodemographic, personal, and disease-related determinants and referral to a new model of health care that uses patient-reported outcomes (PRO) measures for remote outpatient follow-up (PRO-based follow-up).MethodsWe conducted a prospective cohort study among outpatients with epilepsy at the Department of Neurology at Aarhus University Hospital, Denmark. Included were all persons aged ≥ 15 years visiting the department for the first time during the period from May 2016 to May 2018. Patients received a questionnaire containing questions about health literacy, self-efficacy, patient activation, well-being, and general health. We also collected data regarding sociodemographic status, labour market affiliation, and co-morbidity from nationwide registers. Associations were analysed as time-to-event using the pseudo-value approach. Missing data were handled using multiple imputations.ResultsA total of 802 eligible patients were included in the register-based analyses and 411 patients (51%) responded to the questionnaire. The results based on data from registers indicated that patients were less likely to be referred to PRO-based follow-up if they lived alone, had low education or household income, received temporary or permanent social benefits, or if they had a psychiatric diagnosis. The results based on data from the questionnaire indicated that patients were less likely to be referred to PRO-based follow-up if they reported low levels of health literacy, self-efficacy, patient activation, well-being, or general health.ConclusionBoth self-reported and register-based analyses indicated that socioeconomically advantaged patients were referred more often to PRO-based follow-up than socioeconomically disadvantaged patients.
Highlights
In 2019, it was estimated that two-thirds of the adult Danish population have one or multiple chronic conditions, a number that is expected to increase [1]
13% had a high level of comorbidity (Charlson Comorbidity Index > 2) and 12% had a psychiatric disease diagnosis
We found that patients were less likely to be referred to patient-reported outcome (PRO)-based follow-up if they reported a low level of health literacy, self-efficacy, patient activation, well-being, or general health
Summary
In 2019, it was estimated that two-thirds of the adult Danish population have one or multiple chronic conditions, a number that is expected to increase [1] Extended author information available on the last page of the article a growing burden on the healthcare system, and to manage this challenge, several initiatives must be considered by the health authorities. One of these initiatives could be systematic use of patient-reported outcome (PRO) measures at the individual patient level in the healthcare system. The use of PRO measures in individual patient management has several applications; for example, it can facilitate monitoring of symptoms before and after treatment, facilitate communication between patients and clinicians, facilitate early identification of problems, and reduce unnecessary outpatient appointments for stable patients [3, 4]
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