Using Patient Reported Outcomes to Improve Health Care E-Book

John Appleby

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 233

Veröffentlichungsjahr: 2015

Beschreibung

A practical, introductory guide to the best use of Patient Reported Outcomes (PROs) to improve the quality of health care and patient health.

• Only title to exclusively introduce, explain and show how PROs can be best used to improve healthcare and patient outcomes 
• Includes real life examples and case studies of PROs in practice 
• Assesses the growing evidence base for PROs in practice 
• Editor team from Office of Health Economics (OHE), The King's Fund and King’s College London with contributions from practising clinicians, GPs and other healthcare professionals

Leseprobe

Using Patient Reported Outcomes to Improve Health Care

John Appleby

Nancy Devlin

David Parkin

This edition first published 2016 © 2016 by John Wiley & Sons Ltd

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Library of Congress Cataloging-in-Publication Data

Appleby, John, 1958- , author.  Using patient reported outcomes to improve health care / John Appleby, Nancy Devlin, David Parkin.   p. ; cm.  Includes bibliographical references and index.  ISBN 978-1-118-94860-6 (cloth)  I. Devlin, N. J. (Nancy J.), author. II. Parkin, David W., author. III. Title.  [DNLM: 1. Patient Outcome Assessment. 2. Data Collection. 3. Delivery of Health Care–organization & administration.  4. Quality Improvement. W 84.41]  R853.O87  362.1072'7–dc23

2015029809

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

ISBNs

paperback:  978-111-894860-6 ePDF:     978-111-894859-0 epub:     978-111-894858-3

Cover image: GettyImages-185008611/Health Questionaire/Vishwanath Bhat

Gettyimages-493216259/Surgeons performing surgery in operation theatre/Morsa Images

Contents

Foreword

Foreword

Acknowledgements

Chapter 1: Introduction

The economic context

Special issues with measuring and valuing health

A fundamental shift in focus

Routine measurement of PROs: a step forward in the NHS

Getting the most out of patient reported outcomes

References

Notes

Chapter 2: A primer on patient reported outcomes

What are PROs?

How do PROs measure health?

How is a patient’s self-reported health on the various dimensions summarised?

Condition-specific and generic PROs

Subjective health measures

Measuring changes in health

Ways of summarising and presenting PROs

Measurement of overall health

Conclusions

References

Chapter 3: Patients: information and choice

Patient choice

Which treatment?

Which hospital?

Which clinician?

Will PROs make a difference to patients’ choices?

References

Notes

Chapter 4: Clinicians: clinical decision making

Using PROs in clinical practice

Are PROs relevant to decisions about referral?

International use of PROs in referral management

The potential role of points systems in the NHS

PROs and other health professions

References

Chapter 5: Hospitals: managing clinical quality

What PRO data are available to NHS hospitals?

Quality Accounts

Understanding outcome variations

Examining variations in health and health care using PROs

How do provider characteristics affect outcomes measured by PROs?

Incentives

PROs, costs and hospital efficiency

What can the NHS learn from the independent health care sector?

References

Chapter 6: Commissioners: quality, value for money and fairness

Value-for-money from commissioner budgets

PROs and commissioning

Using PROs to choose providers and manage performance

Equitable health outcomes?

References

Chapter 7: Regulation, value for money and productivity

Patient reported outcomes and regulation of health care

Using PRO data to measure cost-effectiveness

Part 1: the benefits

Part 2: the costs and effects

Measuring NHS output and productivity

References

Note

Chapter 8: Where next for patient reported outcomes?

Lessons and challenges

References

Note

Appendix 1

Appendix 2

Appendix 3

Helping patients decide what to do

Patient reported outcome measures: PROMS

Index

EULA

List of Tables

Chapter 2

Table 2.1

Chapter 3

Table 3.1

List of Illustrations

Chapter 2

Figure 2.1 Adjusted and unadjusted EQ-5D index scores for primary hip replacement: English hospitals, 2012–2013: ordered on both adjusted and unadjusted results.

Figure 2.2 Adjusted and unadjusted EQ-5D index scores for primary hip replacement: English hospitals, 2012–2013: ordered on unadjusted results only.

Figure 2.3 Presentation of Paretian Classification of Health Change using EQ-5D profile data before and after four elective procedures.

Figure 2.4 EQ-VAS change before and after varicose vein surgery: percentage reporting improvement or unchanged/worsened. English hospitals: April 2012–March 2013.

Figure 2.5 Case-mix adjusted average health gain: Primary knee replacement, English hospitals, April 2012–March 2013.

Chapter 3

Figure 3.1 PROMs outcomes: April 2012–March 2013. Source: HSCIC (2014)

Figure 3.2 Importance of various factors to patients in choosing a hospital for treatment.

Figure 3.3 Changes in reported health related quality of life for hernia patients: England, April 2012–March 2013 by hospital of treatment.

Figure 3.4 Health gain following hip replacement by hospital: England (2012–2013).

Figure 3.5 Health gain following hip replacement: England, 2012–2013: Illustration of change in confidence intervals with increasing data.

Chapter 5

Figure 5.1 Proportion (%) with moderate and severe problems in the EQ-5D dimension anxiety/depression, by areas in Stockholm, Sweden, women 18–84 years. Source: Burström

et al.

(2014) reproduced with permission.

Figure 5.2 Mean EQ VAS score by area in Stockholm, Sweden, women, 18–84 years. Source: Burström

et al.

(2014) reproduced with permission.

Figure 5.3 Overview of the current self-reported inclusion of PROMs and PREMs in the Swedish National Quality Registers. Source: Burström

et al.

(2014). NB: The most common generic measure was the EQ-5D (around 35 registers) and the SF-36/RAND-36 (around 10 registers). Of the 10% or so reporting not having any PRO or PRE measures in the register, most reported planning for inclusion in the near future. Further, several of the registers already using these measures reported planning for an extended use. NB: ‘Other patient-reported measures’ included measures of work situation, lifestyle factors, and burden of care from the perspectives of the relatives of the patient. (From the 108 annual applications for funding for 2015)

Figure 5.4 Case-mix adjustment: Stylised example

Figure 5.5 Percentage of patients treated in NHS or independent hospitals reporting an improvement in health related quality of life. Source: Data: HSCIC (2014)

Chapter 6

Figure 6.1 Socioeconomic deprivation and health state before operation (hernia and primary knee replacement): English hospitals: April–November 2010.

Chapter 7

Figure 7.1 QALY change following a hip operation: English hospitals (April 2009–August 2010) Source: Appleby

et al.

(2013) Reproduced with permission of Sage Publications.

Figure 7.2 Cost-effectiveness plane for hip replacement surgery: English hospitals (April 2009–August 2010).

Figure 7.3 Contribution to NHS output growth of the quality adjustment factor 2003–2004 to 2010–2011.

Guide

Cover

Table of Contents

Chapter 1

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