Value-based health care in Western countries: a scoping review on the implementation of patient-reported-outcomes sets for hospital-based interventions

ABSTRACT

Introduction

For implementation of the value-based health-care (VBHC) concept, use of patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs), and clinical outcomes is crucial. The aim of this study was to summarize published studies on implemented PROMs, PREMs, and clinical-outcomes sets in health-care practice.

Areas covered

A scoping review was conducted by using PubMed and Embase. Our study focused on implementation examples of patient-reported outcome sets in Western countries’ hospitals. Included papers were analyzed on content, in particular concerning PROMs, PREMs, and clinical outcomes. We also assessed differences between diseases, categorized as patient-reported outcomes in curative, chronic, and palliative treatments in the hospital.

Expert opinion

A total of 20 studies were found that presented VBHC implementation examples. Results illustrate the disconnection between the development of PROMs and PREMs and the implementation phase, with implementation still in infancy. Hospital organizations should enhance organization for the implementation of VBHC. It is crucial that leading examples of successful VBHC serve as blueprints for implementation, with the participation of all relevant stakeholders. Affordability and sustainability of health care can be enhanced by scaling up successful VBHC-interventions on population levels.

KEYWORDS:

• Value-based health care
• scoping review
• patient-reported outcomes
• implementation

Article highlights

• Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are used to actively involve patients in individualized therapy during the entire health-care pathway. Implementation of the value-based health care in hospital-based interventions, is currently not well established.

• Overall, this study assessed implementation examples in the Western world and differences between diseases, specified as patient-reported outcomes in curative, chronic, and palliative treatments in the hospital.

• This study shows the value of implementing this concept in hospitals, and demonstrates the differences between generic (60%), domain-specific (70%), and disease-specific (60%) PROMs. Of all implemented outcome sets, 40% were initiated in a Dutch hospital setting, and 65% of outcome sets were implemented in a single center. This study showed that the implementation of PROMs is widely accepted, but that PREMs are less often implemented in hospital-based intervention settings.

• Integration of CEA and the VBHC concept could lead to a more transparent system that includes data from the patient. Stakeholders need to be cooperative to share data and knowledge on both concepts and integrate these data in their organizations. The future of cure and care could potentially become affordable in an economically favorable and ethically responsible manner if dynamically implement the principles of a concept like VBHC.

Author contributions

All authors: study concept and design, critical revision of the manuscript, and interpretation of data. J Eijsink and A Fabian: data acquisition and management. J Eijsink and A Fabian: drafting of the manuscript. C Boersma and M Postma: study supervision. All authors read and agree for the final version of the manuscript to be published.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper was funded by the Department of Health Sciences, University of Groningen, and Department of Clinical Pharmacy, Isala.