What matters to patients? A timely question for value-based care

Abstract

Background Our healthcare system is moving towards patient-centered and value-based care models that prioritize health outcomes that matter to patients. However, little is known about what aspects of care patients would prioritize when presented with choices of desirable attributes and whether these patient priorities differ based on certain demographics. Objective To assess patients’ priorities for a range of attributes in ambulatory care consultations across five key health service delivery domains and determine potential associations between patient priorities and certain demographic profiles. Methods Using a What Matters to You survey patients ranked in order of importance various choices related to five health service domains (patient-physician relationship, personal responsibility, test/procedures, medications, and cost). Subjects were selected from two Johns Hopkins affiliated primary care clinics and a third gastroenterology subspecialty clinic over a period of 11 months. We calculated the percentage of respondents who selected each quality as their top 1–3 choice. Univariate and multivariate analyses determined demographic characteristics associated with patient priorities. Results Humanistic qualities of physicians, leading a healthy lifestyle, shared decision making (SDM) for medications and tests/procedures as well as knowledge about insurance coverage were the most frequently ranked choices. Privately insured and more educated patients were less likely to rank humanistic qualities highly. Those with younger age, higher educational attainment and private insurance had higher odds of ranking healthy lifestyle as a top choice. Those with more education had higher odds of ranking SDM as a top choice. Conclusions Identifying what matters most to patients is useful as we move towards patient-centered and Value Based Care Models. Our findings suggest that patients have priorities on qualities they value across key health service domains. Multiple factors including patient demographics can be predictors of these priorities. Elucidating these preferences is a challenging but a valuable step in the right direction.

Evaluation of the functional goal‐setting and self‐management tool for osteoarthritis, a patient‐centred tool to improve osteoarthritis care

“…In addition, clinician perceptions of patients' communication abilities seemed to improve. Effective patient‐clinician communication has been associated with quality care and patient expectations (Hirpa et al., 2020; Mohammed et al., 2016), and tools like the FAST‐OA may encourage communication.…”

“…In addition, clinician perceptions of patients' communication abilities seemed to improve. Effective patientclinician communication has been associated with quality care and patient expectations(Hirpa et al, 2020;Mohammed et al, 2016), and tools like the FAST-OA may encourage communication.End-of-project survey responses indicate that clinicians thought the project tools were useful: at baseline, just over half agreed that their practice had tools and resources to help patients meet functional goals, while 70% (n = 12) agreed in the follow-up survey, suggesting perceived utility but also that refinement may improve tool value. Such refinement could focus on maximising highly valued elements like collaborative goal setting.Though most clinicians valued the tool and would recommend use to colleagues, less than half felt use was feasible within a typical OA visit, and 50% were neutral on this question, implying uncertainty about use and that refinements may promote uptake.…”

Patient satisfaction with quality of care of a multidisciplinary thrombosis service – a cross sectional survey

“…Consideration of patient satisfaction and patient reported experiences are becoming more important in the provision of health care [ 1 ]. The move towards patient centred care helps to align health services delivery with what is important to patients.…”

Interest in Telehealth Among Patients With Chronic Retinal Conditions

“…Patients' preferences and values have and will continue to be significant drivers of health care delivery with the potential to improve clinical outcomes, patient satisfaction, and health care costs and disparities. 17,18 To align current and future retinal care paradigms with patient preferences, there is a need to elucidate a patient's interest in telehealth and essential factors that shape their preferences for these programs. Thus, this study's objective was to investigate patients' willingness to involve teleophthalmology in their routine retinal care and assess how features such as age, sex, race, income status by zip code, and diagnoses affect interest in telehealth among patients receiving care for chronic retinal conditions.…”