Enhancing Patient Response to Patient Reported Outcome Measures (PROMs): Insights from a Leading Dutch University Hospital.

IF 4.9 2区 医学 Q1 ECONOMICS Value in Health Pub Date : 2024-10-17 DOI:10.1016/j.jval.2024.09.016
Veerle van Engen, Céline L van Lint, Ingrid A Peters, Kees Ahaus, Martina Buljac-Samardzic, Igna Bonfrer
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Abstract

Objectives: Engaging patients with Patient Reported Outcome Measures (PROMs) is a widely recognized and pressing challenge, yet our understanding of how to achieve this is limited. This study investigated strategies implemented by a Dutch university hospital aimed at enhancing response rates among outpatients from nearly 70 subdepartments. Response rates improved, but remained below desired levels. To deepen understanding and inform future strategies, we identified patient and consultation characteristics associated with response behavior.

Methods: We investigated strategies and their underlying rationales through document analysis of internal hospital documentation (2020-2023) using the COM-B model. We exploited electronic health record data to identify patient and consultation characteristics associated with PROMs completion, estimating a multivariate logistic regression model (n= 46,468 outpatient consultations).

Results: Thirteen strategies targeted outpatients' capability, opportunity, and motivation to complete PROMs. In 2023, PROMs were completed in over half (56%) of the 46,468 unique consultations for which a PROM was sent. Challenges persisted in establishing effective feedback mechanisms and accommodating non-Dutch speaking patients. The multivariate analysis showed significantly higher response among patients of high or middle socioeconomic status and those with an in-person consultation, i.e. not using telehealth. Women, patients attending a follow-up visit, or those having their consultation on a Friday were slightly less likely to complete PROMs.

Conclusions: Response rates to PROMs improved but remained below desired levels, despite multiple strategies. Hospitals may benefit from effective patient feedback on PROMs and tailoring strategies to engage specific patient groups. These approaches can enhance successful implementation and promote equity in VBHC.

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增强患者对患者报告结果衡量指标(PROMs)的反应:荷兰一所顶尖大学医院的启示。
目的:让患者参与 "患者报告结果测量"(PROMs)是一项广受认可且亟待解决的挑战,但我们对如何实现这一目标的了解却十分有限。本研究调查了荷兰一所大学医院为提高近 70 个分科门诊患者的回复率而实施的策略。回复率有所提高,但仍低于预期水平。为了加深理解并为未来的策略提供依据,我们确定了与回复行为相关的患者和就诊特征:我们采用 COM-B 模型,通过对医院内部文件(2020-2023 年)进行文档分析,研究了相关策略及其基本原理。我们利用电子健康记录数据确定了与 PROMs 完成情况相关的患者和就诊特征,并估算了一个多变量逻辑回归模型(n= 46,468 个门诊就诊者):13项策略针对门诊患者完成PROMs的能力、机会和动机。2023 年,在 46,468 个发送了 PROM 的门诊患者中,超过一半(56%)的患者完成了 PROM。在建立有效的反馈机制和照顾不讲荷兰语的患者方面仍存在挑战。多变量分析表明,社会经济地位高或中等的患者,以及亲自就诊(即未使用远程医疗)的患者的回复率明显较高。女性患者、复诊患者或周五就诊的患者填写 PROMs 的可能性略低:结论:尽管采取了多种策略,PROMs 的回复率有所提高,但仍低于预期水平。医院可从患者对 PROMs 的有效反馈以及针对特定患者群体的定制策略中获益。这些方法可以提高 VBHC 的成功实施率并促进公平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Value in Health
Value in Health 医学-卫生保健
CiteScore
6.90
自引率
6.70%
发文量
3064
审稿时长
3-8 weeks
期刊介绍: Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.
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