Understanding and using patient experiences as evidence in healthcare priority setting.
Decision-making
Patient experience
Patient involvement
Priority setting
Public involvement
Resource allocation
Journal
Cost effectiveness and resource allocation : C/E
ISSN: 1478-7547
Titre abrégé: Cost Eff Resour Alloc
Pays: England
ID NLM: 101170476
Informations de publication
Date de publication:
2019
2019
Historique:
received:
09
09
2018
accepted:
03
09
2019
entrez:
2
10
2019
pubmed:
2
10
2019
medline:
2
10
2019
Statut:
epublish
Résumé
In many countries, committees make priority-setting decisions in order to control healthcare costs. These decisions take into account relevant criteria, including clinical effectiveness, cost-effectiveness, and need, and are supported by evidence usually drawn from clinical and economic studies. These sources of evidence do not include the specific perspective and information that patients can provide about the condition and treatment. Drawing on arguments from political philosophy and ethics that are the ethical basis for many priority-setting bodies, the authors argue that criteria like need and its effects on patients and caregivers are best supported by evidence generated from patients' experiences. Social sciences and mixed-methods research support the generation and collection of robust evidence. Patient experience is required for a decision-making process that considers all relevant evidence. For fair priority-setting, decision-makers should consider relevant evidence and reasons, so patient experience evidence should not be ignored. Patient experience must be gathered in a way that generates high quality and methodologically rigorous evidence. Established quantitative and qualitative methods can assure that evidence is systematic, adherent to quality standards, and valid. Patient, like clinical, evidence should be subject to a transparent review process. Considering all relevant evidence gives each person an equal opportunity at having their treatment funded. Patient experience gives context to the clinical evidence and also directly informs our understanding of the nature of the condition and its effects, including patients' needs, how to meet them, and the burden of illness. Such evidence also serves to contextualise reported effects of the treatment. The requirement to include patient experience as evidence has important policy implications for bodies that make priority-setting decisions since it proposes that new types of evidence reviews are commissioned and considered.
Sections du résumé
BACKGROUND
BACKGROUND
In many countries, committees make priority-setting decisions in order to control healthcare costs. These decisions take into account relevant criteria, including clinical effectiveness, cost-effectiveness, and need, and are supported by evidence usually drawn from clinical and economic studies. These sources of evidence do not include the specific perspective and information that patients can provide about the condition and treatment.
METHODS
METHODS
Drawing on arguments from political philosophy and ethics that are the ethical basis for many priority-setting bodies, the authors argue that criteria like need and its effects on patients and caregivers are best supported by evidence generated from patients' experiences. Social sciences and mixed-methods research support the generation and collection of robust evidence.
RESULTS
RESULTS
Patient experience is required for a decision-making process that considers all relevant evidence. For fair priority-setting, decision-makers should consider relevant evidence and reasons, so patient experience evidence should not be ignored. Patient experience must be gathered in a way that generates high quality and methodologically rigorous evidence. Established quantitative and qualitative methods can assure that evidence is systematic, adherent to quality standards, and valid. Patient, like clinical, evidence should be subject to a transparent review process.
DISCUSSION
CONCLUSIONS
Considering all relevant evidence gives each person an equal opportunity at having their treatment funded. Patient experience gives context to the clinical evidence and also directly informs our understanding of the nature of the condition and its effects, including patients' needs, how to meet them, and the burden of illness. Such evidence also serves to contextualise reported effects of the treatment. The requirement to include patient experience as evidence has important policy implications for bodies that make priority-setting decisions since it proposes that new types of evidence reviews are commissioned and considered.
Identifiants
pubmed: 31572067
doi: 10.1186/s12962-019-0188-1
pii: 188
pmc: PMC6757378
doi:
Types de publication
Journal Article
Langues
eng
Pagination
20Informations de copyright
© The Author(s) 2019.
Déclaration de conflit d'intérêts
Competing interestsSU is an employee of NICE, working for the Highly Specialised Technologies Evaluation Committee. MS is a member of NICE's Highly Specialised Technologies Evaluation Committee. LR was an employee of the National Academies of Sciences, Engineering, and Medicine at the time this article was written. The views expressed here are those of the authors and do not necessarily reflect those of NICE or the National Academies of Sciences, Engineering, and Medicine.
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