HEALTH CARE OUTPUT

Measuring Health Care Output



Measuring Health Care Output

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A greater understanding of patients' preferences for mode of treatment is central to current models of shared patient-doctor decision making. It is also of potential importance in enhancing patient adherence to treatment and, in turn, patients' health outcomes. Health services, with their emphases on patient involvement and satisfaction, audit and clinical governance, increasingly aim to be responsive to patients' concerns and ultimately to enhance the quality of health care(Kamlet, 2010: 135).

A preference is the expression of a value for alternative options for action after informed deliberation of their risks and benefits. Research on patients' preferences for type of treatment has been relatively neglected, but has received some attention in oncology and cardiology (for example, atrial fibrillation). Both the exploration of patients' preferences for treatment options and patients' understandings of the risk associated with treatment is attracting increasing attention. This is partly a consequence of society's awareness of the need for a better informed public, of demands for information from patients and their representatives, a litigation conscious society, and media exposures of the riskiness of modern society.

There is a need for population based data on patients' preferences for treatment in order to inform health policy. Given that clinical decisions must be made at the individual level, there is a need for the further development of decision making tools for use in clinical practice which elicit and incorporate, not only patients' utilities or preferences for general health states (outcomes),1 but also preferences for the treatment options available, after consideration of their risks as well as the benefits. The dynamic nature of cognitive processes also needs to be taken into account. While Leydon et al8 reported that cancer patients need “faith, hope and charity” which limited their desire for information, this is likely to vary ...