new ways to look at health and healthcare outcomes: focusing on patients’ perspectives and values
DESCRIPTION
Patricia Katz, Jonathan Showstack, Ed Yelin, James Smith, and colleagues in the PRL-IHPS and the Arthritis Research GroupTRANSCRIPT
New Ways to Look at Health and Healthcare Outcomes: Focusing on Patients’ Perspectives and ValuesPatricia Katz, Jonathan Showstack, Ed Yelin, James Smith, and colleagues in the PRL-IHPS and the Arthritis Research
GroupIssue: Traditionally, patient health status and
effects of healthcare were based on outputs of the medical system
Newer trends focus on patients’ perspectives:• Satisfaction with medical care• Self-reports of symptoms and functioning• Personal values and experiences
PRL-IHPS Faculty have led efforts to
incorporate patient-centered measures in a
variety of arenas
Example 1: Fertility Experiences Project• Quantified time expenditures and out-of-pocket costs of
infertility treatment, as well as total medical costs• Identified risk of depression following treatment failure and
social impact of infertility• Found disparities in access to infertility treatment
Implications:• Current policies surrounding infertility treatment produce
huge disparities in access to care and provide incentives for treatment options that produce greater costs after conception (i.e., costs of multiple births)
Example 2: Measurement of Disability andFunctioning
• Standard measures of disability focus on low levels of functioning, such as ability to eat or rise from toilet
• Patients experience disruptions in activity long before these basic activities are affected
• New measure of disability asks about effects of health on a range of activities, from very basic activities to household tasks to social and recreational activities and work, and allows people to express the value of the activity
Implications:• Measures impact of health that are important to patients• Focused on patients’ functional goals• Can be used to target interventions before more serious
disability occurs