Using Patient Reported Outcomes to Improve Health Care

Professor John Appleby is chief economist at the King’s Fund. He has worked in the National Health Service in Birmingham and London, and as senior lecturer at the universities of Birmingham and East Anglia. He is a regular contributor to the British Medical Journal on health and economic issues and has acted as an adviser to the UK government and parliament in various capacities. Professor Appleby is also a Visiting Professor at the Department of Economics at City University, London and at the Institute of Global Health Innovation, Imperial College London. Professor Nancy Devlin’s principal areas of research expertise are the measurement and valuation of patient reported health outcomes; the cost effectiveness thresholds used in making judgments about value for money in health care; priority setting in health care; production, performance and efficiency of hospitals; and the determinants of patient choice. Professor Devlin holds honorary chairs at the Centre for Health Economics, University of York; Cass Business School, London; and in the Economics Department at City University, London. She is the elected Chair of the EuroQol Group, a European-based international network of researchers that developed the EQ-5D. Professor David Parkin is Professor of Health Economics at King’s College London.  He has held academic appointments at the Universities of Manchester, Aberdeen and Newcastle and at City University London, and was formerly Chief Economist at NHS South East Coast.  He is co-author of a popular Health Economics textbook Economic Analysis in Health Care (Wiley, 2012), contributor to other health economics books including Econometric Analysis of Health Data (Wiley, 2002) and is author of many published papers.  He has been a member of the EuroQol group, the developer and owner of the EQ-5D, since 1998.

Foreword, Sir Bruce Keogh, vi

Foreword, An international perspective, Professor Kalipso Chalkidou,vii

Acknowledgements, ix

1 Introduction, 1

2 A primer on patient reported outcomes, 9

3 Patients: information and choice, 27

4 Clinicians: clinical decision making, 41

5 Hospitals: managing clinical quality, 51

6 Commissioners: quality, value for money and fairness, 70

7 Regulation, value for money and productivity, 75

8 Where next for patient reported outcomes?, 88

Appendix 1 PROM questionnaire that is currently completed by patients after undergoing varicose vein surgery, 91

Appendix 2 The EQ-5D-5L©, 101

Appendix 3 Dr Tim Hughes’ shared decision-making aid for patients, 103

Index, 107