VBHC - week 5

Question 1

Value-Based Health Care

Answer 1

“value defined as the health outcomes achieved per dollar spent” – According to Porter and Teisberg

Question 2

Which outcomes? according to Porter

Answer 2

Health status achieved of retained
* Survival
* Degree of health or recovery
Process of recovery
* Time to recovery or return to normal activities
* Disutility of care or treatment process
Sustainability of health
* Sustainability of health or recovery and nature of recurrences
* Long-term consequences of treatment

Question 3

Measuring outcomes
According to Porter:

Answer 3

• “systematic outcomes measurement is the sine qua non of value improvement”
• “outcomes measurement must accelerate”
• “That means committing to measuring a minimum sufficient set of outcomes for every major medical condition — with well-defined methods for their collection and risk adjustment — and then standardizing those sets nationally and globally”

Question 4

ICHOM standard sets

Answer 4

• 28 standard sets of outcome measures;
  o Focus on the whole range of possible treatments
  o Whole episode of care
• Covering different conditions and for specific patient populations;
• Defined by global teams of patient advocates, healthcare professionals and researchers.

Question 5

January 2017: start collaboration of ICHOM & OECD
Why OECD? (Organisation for Economic Co-operation and Development)

Answer 5

• International organisation; headquarters in Paris
• Partner of G20 and G7; co-operate with European Commission
• Members: 36 countries in North and South America, Europe and Asia-Pacific
• Focus on: economic performance, education, health and social care
• Works through: thematic committees, expert and working groups, conferences etc.
• Participants: representatives from governments, parliaments, business, labour, non-governmental organisations and academia

Question 6

PROMs and PREMs

Answer 6

PROMs= Patient Reported Outcome Measures, e.g.
* Hip disability and Osteoarthritis Outcome Score (HOOS), measures e.g.:
o Pain while walking on flat surface or bending hip
o Difficulty going up or down stairs, or squatting or running
PREMs= Patient Reported Experience Measures, e.g.
* Consumer Assessment of Health Care Providers and Systems (CAHPS), measures e.g.:
o Communication with doctors and nurses
o Quality of discharge information

Question 7

Aims of PaRIS

Answer 7

• Show how outcomes vary across and within countries;
• Allow countries to benchmark;
• Unit of analysis = country  is different from VBHC even though they use the same outcome measures
  ≠ diagnostic or curative intervention
  ≠ care pathway
  ≠ healthcare provider