Patient-reported outcome measures in value-based healthcare: A multiple methods study to assess patient-centredness.

Abstract

Value-based healthcare (VBHC) involves the use of standardised outcome measures, including patient-reported outcome measures (PROMs). This study aimed to assess to what extent discussion of PROMs is associated with patient- and person-centredness. This study used a separate sample pre-/post-test design and multiple methods (observations, questionnaires, and interviews) in a VBHC care pathway for patients with a vestibular schwannoma, to assess to what extent the implementation of PROMs is associated with a difference in patient- and person-centredness. A total of 139 patients with a vestibular schwannoma and their four treating physicians were included in the study. No significant differences were found in observed patient-centredness (M_pre=6.71 ± 2.42 vs. M_post=6.93 ± 2.01; P = 0.60) or patient-reported patient-centredness (M_pre=1.73 vs. M_post=1.68; P = 0.63) and person-centredness after PROM implementation (M_pre=11.81 vs. M_post=13.42; P = 0.34). We observed more discussion of patient-reported outcomes. However, a majority of patients did not expect PRO discussion in consultations. The implementation of standardised PROMs in a VBHC care pathway was associated with more discussion on patient-reported outcomes in clinical consultations. Overall, the implementation of PROMs was not observed or perceived as leading to more patient-centred consultations. Physicians should assess whether the discussion of PROMs add value collaboratively with patients.