Humanistic Outcomes Flashcards
What is the ECHO model?
economic (payer-centred)
-direct, indirect and intangible monetary value
clinical (provider-centred)
-changes in morbidity, mortality, biological markers
humanistic (patient-centred)
-utility (preferred state of health)
-functional status
-willingness to pay
-patient satisfaction
Which outcomes do health providers and systems tend to focus on?
clinical and economic aspects of health care
-often fail to fully consider the social aspects of disease and illness, or to recognize patients actual experiences when interacting with the health care system (both good and bad)
-humanistic outcomes are increasingly seen as important when assessing the effectiveness of health care services
What is the question that humanistic outcomes seek to answer?
what is the patient experiencing and how does the service/intervention affect the patients quality of life?
What is a QALY?
quality-adjusted life years
-a humanistic outcome measure commonly used in health economic evaluation studies
-QALY=utility x time
-based on utility or the patients preference or perceived value for a particular health state, and time in that state
What is functional status?
looks at dimensions of health and wellbeing that affect ones ability to carry out the “activities of daily living”
What are the dimensions considered regarding functional status?
physical (vision, hearing, speech, ambulation, dexterity)
mental (cognition, emotional well-being)
social interaction
energy
level of pain
What is an example of a survey that assesses functional status?
SF-36
Provide a brief description of the SF-36.
35 items create 8 subscales each with a maximum score of 100
+ one item: health change
subscales:
-general health
-physical functioning
-role physical
-role emotional
-social functioning
-bodily pain
-mental health
-vitality
What is the disadvantage of the SF-36? What is often the solution?
can take substantial time to complete
researches may opt for shorter instruments with comparable reliability and validity
-SF 12
What is the difference between generic and disease specific instruments?
generic provide a general assessment of HRQL
-lack the sensitivity needed to measure the effect of an intervention on a particular health condition
disease-specific is focused on one disease
-provide greater sensitivity; but may not capture all the benefits of an intervention
Which type of instrument is recommended when assessing the effect of an intervention on HRQL?
both a generic and a disease-specific
What is willingess-to-pay?
based in economic theory
-assigns a monetary value for an outcome
What are the two ways to assess willingness-to-pay?
indirect
-inferred from observing behavior
direct
-open: respondents are asked to state dollar amount they are willing to pay
-closed: respondents asked if willing to pay a specified price (yes/no)
How is willingness-to-pay often employed by pharmaceutical companies?
to determine the price for a new drug
-present research participants with hypothetical scenarios involving different service or drug attributes identified as important (discrete choice scenarios)
What is patient satisfaction?
evaluation of the quality of care received
-the patient/client perspective on process
What are some attributes evaluated by patients/clients for patient satisfaction?
accessibility of care
continuity of care
comprehensiveness of care
integration of specific care into overall care
Describe the way that patient satisfaction is currently trending towards.
focus shifting from dispensary functions, error rates and costs toward patient care services
What are PROMs?
patient reported outcome measures
-used to assess a patients health status
-can be used to measure the impact of an intervention
-supports a patient-centered approach
What are types of PROMs?
health-related quality of life
functional status
symptoms and symptom burden
patient experience of care
What are PREMs?
patient reported experience measures
-helps you be a better practitioner
-based on standards, patient then says yes/no that x occurred
