Patient-Reported Outcomes and Waiting for Elective Surgery: Preliminary Findings Jason M. Sutherland...
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Transcript of Patient-Reported Outcomes and Waiting for Elective Surgery: Preliminary Findings Jason M. Sutherland...
Patient-Reported Outcomes and Waiting for Elective Surgery:
Preliminary FindingsJason M. Sutherland
Centre for Health Services and Policy ResearchUniversity of British Columbia
The Taming of the QueueAppropriateness and Accountability
April 4, 2014
Disclosure
The research presented today is funded by:• Canadian Institute for Health Research (CIHR)• Vancouver Coastal Health Authority (in-kind)
Approved by:• University of British Columbia Behavioural
Research Ethics Board• Vancouver Coastal Health Authority Privacy Office
Source: CIHI, CMS National Health Expenditure Historical Data
SpendingAnnual % change in total health and hospital spending, 1981-2012
How are we doing?
Commonwealth Fund 2013
Germany
Switzerland
USA
Netherlands
New Zealand
France
UK
Australia
Sweden
Norway
Canada
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
waited 4 months or more for elective surgery waited 2 months or more for specialist apt
What is missing?
Collect and measure patient-reported outcomes
• Completed by patients• Standardized, validated questionnaires• Measure self-perceived quality of life, functional
well-being and health status
• Generic or condition-specific
Elective surgery– Measure patient’s reported outcomes prospectively– Evaluate changes in patients’ health over time
Self-reported health on the wait listMethods
• 7 specialties; 6 hospitals in metro Vancouver region
Self-reported health on the wait listMethods
Gen
eral
Surg
ery
Plast
ics
Gyn
ecol
ogy
Oto
lary
ngolog
y
Urolo
gy
Orthop
edics
Neu
rosu
rger
y
44%
16%13% 12%
7% 5%2%
Response Rate:• Entering wait list: 45 %• Just before surgery: 68 %
Self-reported health statusEQ-5D
Five domains:
1. Mobility2. Self-care3. Usual activities4. Pain / discomfort5. Anxiety / depression
AND A ranking of overall health status
Self-reported pain
Three domains:
1. Intensity of pain2. Pain interference in
enjoyment of life3. Pain interference with
general activity
Self-reported health
What does a patient’s self-reported health tell us at the start of their wait time?
1. Aspects of health are very good:• Usual activities• Function and Mobility
2. Largest potential for improving patient’s health:• Anxiety / Depression• Pain