DEVELOPMENT OF A CONCEPTUAL FRAMEWORK OF "GOOD HEALTHCARE" FROM THE PATIENT'S PERSPECTIVE
Author(s)
McCaffrey S, Chan C, Hoole M, Chiauzzi E
PatientsLikeMe, Cambridge, MA, USA
OBJECTIVES: Research is lacking on the most important aspects of care and clinician performance from the patient’s perspective. Utilizing concept mapping (CM), a mixed method (qualitative and quantitative), the primary objective of this study was to conceptualize “good healthcare” and aspects of healthcare that matter most to patients. Secondary objectives evaluated differences in prioritizing aspects of healthcare among (1) various patient populations and (2) patients and stakeholders. METHODS: This study consisted of two phases, (1) statement generation, and (2) CM. Statements about what constitutes “good healthcare” were generated from literature review, stakeholder interviews (clinicians, researchers, purchasers, measure developers, health IT) and survey of patients (n=157) and stakeholders (n=17), via the online Open Research Exchange platform of PatientsLikeMe (a social network for patients with life-changing medical conditions). The majority of patients in phase I self-identified as female (71%), White (85%), and Non-Hispanic (92%) with a mean age of 56 years, and reported 68 different primary diagnoses. The statement pool (n=1300) was reduced to 79 statements for CM. In the second phase, using ConceptSystems software, stakeholders (n=15) and patients (n=172) rated these statements on importance and sorted the statements into meaningful categories. The majority of patients in phase II self-identified as female (64%), White (82%), Non-Hispanic (86%) with a mean age of 57 years, and reported 51 different primary diagnoses. RESULTS: Preliminary results produced an 8-factor solution: (1) Doctor-Patient Communication, (2) Doctor Characteristics and Behavior, (3) Appropriate Care, (4) Outcomes, (5) Patient as an Active and Informed Participant in Their Care, (6) Office Attributes, (7) Team Communication, and (8) Insurance Limitations. Pattern matching (cluster ratings of importance) across various demographic/clinical variables (e.g., gender) revealed similar results across groups. CONCLUSIONS: The conceptual model generated from this study is the first step towards developing patient-reported performance measures, and may also have public policy implications.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
PHP230
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Health Care Research
Disease
Multiple Diseases