1 / 25

The contribution of PROMs to health care sustainability

The contribution of PROMs to health care sustainability. Mark Harrison Stirling Bryan Deborah Marshall Nick Bansback. PROMs definitions. Patient-reported outcome measures ‘PROMs’ Short, self-completed questionnaires Measure impact of illness/health condition, from patient perspective

bfales
Download Presentation

The contribution of PROMs to health care sustainability

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The contribution of PROMs to health care sustainability Mark Harrison Stirling Bryan Deborah Marshall Nick Bansback

  2. PROMs definitions • Patient-reported outcome measures ‘PROMs’ • Short, self-completed questionnaires • Measure impact of illness/health condition, from patient perspective • Quality of life, symptom severity, functional status, health status • Monitor progress of condition, effectiveness of treatment • Change over time • Assess quality of care/services CIHI. PROMs Background Document. 2015. Available from: https://www.cihi.ca/sites/default/files/document/proms_background_may21_en-web.pdf

  3. Generic vs. Condition Specific • Generice.g. HUI, EQ-5D, SF- instruments • Comparable across diseases, sectors, against norms • Cost-effectiveness analysis • Condition/Disease/Population specific e.g. Oxford Knee Score, Seattle Angina Questionnaire • Developed for a specific setting • Sensitive to change/differences between people within condition • Detail & clinical decision making

  4. Routine PROMs collection: Canada • British Columbia • PEAK Project • Knee arthroplasty (EQ-5D, SF-12) CIHI. PROMs Background Document. 2015. Available from: https://www.cihi.ca/sites/default/files/document/proms_background_may21_en-web.pdf

  5. Routine PROMs collection: Canada • British Columbia • PEAK Project • Knee arthroplasty (EQ-5D, SF-12) • Alberta • Hip & knee arthroplasty (SF-36, WOMAC) • Heart & Lung Transplant Clinic • U of Alberta Hospital (HUI2, HUI3) CIHI. PROMs Background Document. 2015. Available from: https://www.cihi.ca/sites/default/files/document/proms_background_may21_en-web.pdf

  6. Routine PROMs collection: Canada • British Columbia • PEAK Project • Knee arthroplasty (EQ-5D, SF-12) • Alberta • Hip and knee arthroplasty (SF-36, WOMAC) • Heart and Lung Transplant Clinic • U of A Hospital (HUI2, HUI3) • Saskatchewan • Joint arthroplasty (EQ-5D) • Spinal surgery (EQ-5D) CIHI. PROMs Background Document. 2015. Available from: https://www.cihi.ca/sites/default/files/document/proms_background_may21_en-web.pdf

  7. Routine PROMs collection: Canada • British Columbia • PEAK Project • Knee arthroplasty (EQ-5D, SF-12) • Alberta • Hip and knee arthroplasty (SF-36, WOMAC) • Heart and Lung Transplant Clinic • U of A Hospital (HUI2, HUI3) • Saskatchewan • Joint arthroplasty (EQ-5D) • Spinal surgery (EQ-5D) • Manitoba • Winnipeg Joint Replacement Group • (SF-12, Oxford Scores) CIHI. PROMs Background Document. 2015. Available from: https://www.cihi.ca/sites/default/files/document/proms_background_may21_en-web.pdf

  8. Routine PROMs collection: Canada • British Columbia • PEAK Project • Knee arthroplasty (EQ-5D, SF-12) • Alberta • Hip and knee arthroplasty (SF-36, WOMAC) • Heart and Lung Transplant Clinic • U of A Hospital (HUI2, HUI3) • Saskatchewan • Joint arthroplasty (EQ-5D) • Spinal surgery (EQ-5D) • Manitoba • Winnipeg Joint Replacement Group • (SF-12, Oxford Scores) • Ontario • Electronic Rheumatology (eRHeum) and Initiatives Research Program (SF-36) CIHI. PROMs Background Document. 2015. Available from: https://www.cihi.ca/sites/default/files/document/proms_background_may21_en-web.pdf

  9. Routine PROMs collection: Canada • British Columbia • PEAK Project • Knee arthroplasty (EQ-5D, SF-12) • Alberta • Hip and knee arthroplasty (SF-36, WOMAC) • Heart and Lung Transplant Clinic • U of A Hospital (HUI2, HUI3) • Saskatchewan • Joint arthroplasty (EQ-5D) • Spinal surgery (EQ-5D) • Manitoba • Winnipeg Joint Replacement Group • (SF-12, Oxford Scores) • Ontario • Electronic Rheumatology (eRHeum) and Initiatives Research Program (SF-36) • National: • Rick Hansen Research Institute, Spinal Cord Injury Registry (SF-36) • Statistics Canada, Canadian Community Health Survey (HUI, RAND SF-36) • Canadian Multicentre Osteoporosis Study (HUI, SF-36) CIHI. PROMs Background Document. 2015. Available from: https://www.cihi.ca/sites/default/files/document/proms_background_may21_en-web.pdf

  10. Sustainability Issues of health care sustainability

  11. Sustainability Issues of health care sustainability

  12. Sustainability Issues of health care sustainability How PROMs can contribute to sustainability

  13. The wedge: unsustainable health care “Business as usual” “Sustainable” (equal to growth in GDP) From: Eliminating Waste in Health Care JAMA. 2012;307(14):1513-1516. doi:10.1001/jama.2012.362

  14. The wedge: sources of waste “Business as usual” Failure of care delivery Failure of co-ordination of care Overtreatment Administrative issues Pricing failure Fraud and abuse “Sustainable” (equal to growth in GDP) From: Eliminating Waste in Health Care JAMA. 2012;307(14):1513-1516. doi:10.1001/jama.2012.362

  15. The wedge: the cheese “Business as usual” Care delivery failure Poor co-ordination Overtreatment Waste & inefficiency Administrative issues Pricing failure Fraud and abuse “Sustainable” (equal to growth in GDP) From: Eliminating Waste in Health Care JAMA. 2012;307(14):1513-1516. doi:10.1001/jama.2012.362

  16. The potential of PROMs to improve efficiency

  17. Roles for routinely collected PROMs • Allocative efficiency • Which treatments to offer and to who • Which treatment is best for a given patient • Technical efficiency • Performance • Comparison of performance • Accountability • Are health resources being spent wisely • Health system level performance Smith & Street. Health Econ. 22: 119-131 (2013)

  18. Stirling Bryan PROMs: from technology appraisal to technology management

  19. Deborah Marshall PROMs as an outcome for continuous quality improvement

  20. Nick Bansback PROMs to support informed patient decision-making

  21. Format 3 presentations of 15 mins 5 mins for questions after each presentation Open discussion

  22. Disclosures Nothing relevant • I hold the UBC Professorship in Sustainable Health Care, which is funded by: Amgen Canada Inc.; AstraZeneca Canada Inc.; GlaxoSmithKline Inc.; Merck Canada Inc.; Novartis Pharmaceuticals Canada Inc.; Pfizer Canada Incorporated; BoehringerIngelheim (Canada) Ltd.; Hoffman-La Roche Ltd.; LifeScan Canada Ltd.; and Lundbeck Canada Inc. • These companies are represented on my advisory council, offering advice/input but not mandatory recommendations.

More Related