Using Patient Reported Outcomes to Improve Health Care

A patient–reported outcome (PRO) draws on patients answers to a series of questions in order to quantify their views on their own health. The purpose of PROs is to get patients′ own assessment of their health and health–related quality of life. The aim of this new title is to provoke and encourage thinking about the wide range of ways in which PRO data, routinely collected in the context of health service delivery, can be used to inform decisions, for example; 

What opportunities do these data present? What are the limitations of PROs, and what are the possible pitfalls in the use and interpretation of data produced from them? What work needs to be done in order to get the most out of PRO data? What have been the experiences of the English NHS with its PROs programme and what can other health systems learn?

Using Patient Reported Outcomes to Improve Health Care provides an overview and explanation of PRO instruments and how PROs data might be used by patients in choosing both where to receive treatment, and also what treatment is best for them.

Throughout this book, and drawing on international examples, the Authors consider ways in which the collected data can be used to transform decision–making in healthcare organisations, by those who commission health care and assess value for money, and also how data can be used to benchmark and improve clinical performance. The authors also discuss how clinicians on a more day to day level might use data to guide referral practices, ensuring that the people who receive health care are those that will benefit from it the most.

This new title is the only resource 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

Foreword, Sir Bruce Keogh, vi

Foreword, An international perspective, Professor Kalipso Chalkidou,vii

Acknowledgements, ix

1 Introduction, 1

2 A primer on patient reported outcomes, 9

3 Patients: information and choice, 27

4 Clinicians: clinical decision making, 41

5 Hospitals: managing clinical quality, 51

6 Commissioners: quality, value for money and fairness, 70

7 Regulation, value for money and productivity, 75

8 Where next for patient reported outcomes?, 88

Appendix 1 PROM questionnaire that is currently completed by patients after undergoing varicose vein surgery, 91

Appendix 2 The EQ–5D–5L©, 101

Appendix 3 Dr Tim Hughes shared decision–making aid for patients, 103

Index, 107

Professor John Appleby is chief economist at the King s Fund. He has worked in the National Health Service in Birmingham and London, and as senior lecturer at the universities of Birmingham and East Anglia. He is a regular contributor to the British Medical Journal on health and economic issues and has acted as an adviser to the UK government and parliament in various capacities. Professor Appleby is also a Visiting Professor at the Department of Economics at City University, London and at the Institute of Global Health Innovation, Imperial College London.

Professor Nancy Devlin s principal areas of research expertise are the measurement and valuation of patient reported health outcomes; the cost effectiveness thresholds used in making judgments about value for money in health care; priority setting in health care; production, performance and efficiency of hospitals; and the determinants of patient choice. Professor Devlin holds honorary chairs at the Centre for Health Economics, University of York; Cass Business School, London; and in the Economics Department at City University, London. She is the elected Chair of the EuroQol Group, a European–based international network of researchers that developed the EQ–5D.

Professor David Parkin is Professor of Health Economics at King s College London.  He has held academic appointments at the Universities of Manchester, Aberdeen and Newcastle and at City University London, and was formerly Chief Economist at NHS South East Coast.  He is co–author of a popular Health Economics textbook Economic Analysis in Health Care (Wiley, 2012), contributor to other health economics books including Econometric Analysis of Health Data (Wiley, 2002) and is author of many published papers.  He has been a member of the EuroQol group, the developer and owner of the EQ–5D, since 1998.