Use of Clinical Outcomes Assessments (COAS) By Hospitals in the USA, UK, France and Sweden: Multi-Stakeholder Viewpoints

Speaker(s)

Sherafat R1, Conway K1, Lewis HB2, Moshkovich O3, Michel A4, Lanar S2, Wang S3, Galinsky J2, Bothorel S1
1Mapi Research Trust, Lyon, 69, France, 2ICON plc, Reading, UK, 3ICON Plc, San Francisco, CA, USA, 4ICON plc, Lyon, 69, France

Presentation Documents

OBJECTIVES: Clinical Outcome Assessment (COA) tools have the potential to be used as quality measures in Value-based Health Care (VBHC). Interviews with hospital and payer representatives and COA developers were conducted to understand how stakeholders view hospital use of COAs in general and with respect to VBHC.

METHODS:

Interviewees were selected from hospital and payer sectors in each country according to the context and structure of the healthcare system. Seven hospital and 10 payer representatives (from private and public sectors) in the USA, UK, France, Sweden as well as 4 COA developers were recruited.

Structured interviews were carried out using an interview guide with open-ended questions. This was designed based on a priori framework of use of COAs in clinical practice and principles of quality measurement in VBHC. Thematic analysis was carried out on interview results.

RESULTS: Hospitals use COAs in a variety of different ways, specifically in individual patient care and treatment monitoring (e.g. cardiology, neurology, sleep medicine). Use of COAs as quality measures for hospital quality improvement and/or VBHC was mentioned only by approximately half of the interviewees from the USA, regardless of private or public status. Barriers to use of COAs in hospitals included lack of IT structure and resources, and inadequacy of evidence of validity, usefulness and interpretation. Drivers for use of COAs in VBHC included encouragement from public/national payer and health authorities. COA developers are not systematically involved in hospitals’ decision to use a COA.

CONCLUSIONS:

The use of COAs by hospitals in quality assessment and VBHC is limited/fragmented. Endorsement by medical authorities and incentivization by payers may promote use of COAs in VBHC. Interview findings will be used to develop a survey of approximately 3000 hospitals and medical practices to gain a broader understanding of if/how COAs are used including VBHC.

Code

HPR128

Topic

Clinical Outcomes, Health Policy & Regulatory

Topic Subcategory

Clinical Outcomes Assessment, Insurance Systems & National Health Care

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory), Mental Health (including addition), Neurological Disorders