Value redefined for inflammatory bowel disease patients: a choice-based conjoint analysis of patients’ preferences
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Value-based healthcare is an upcoming field. The core idea is to evaluate care based on achieved outcomes divided by the costs. Unfortunately, the optimal way to evaluate outcomes is ill-defined. In this study, we aim to develop a single, preference based, outcome metric, which can be used to quantify overall health value in inflammatory bowel disease (IBD).
IBD patients filled out a choice-based conjoint (CBC) questionnaire in which patients chose preferable outcome scenarios with different levels of disease control (DC), quality of life (QoL), and productivity (Pr). A CBC analysis was performed to estimate the relative value of DC, QoL, and Pr. A patient-centered composite score was developed which was weighted based on the stated preferences.
We included 210 IBD patients. Large differences in stated preferences were observed. Increases from low to intermediate outcome levels were valued more than increases from intermediate to high outcome levels. Overall, QoL was more important to patients than DC or Pr. Individual outcome scores were calculated based on the stated preferences. This score was significantly different from a score not weighted based on patient preferences in patients with active disease.
We showed the feasibility of creating a single outcome metric in IBD which incorporates patients’ values using a CBC. Because this metric changes significantly when weighted according to patients’ values, we propose that success in healthcare should be measured accordingly.
KeywordsPatient preferences Outcome measurement Value equation Value-based health care Inflammatory bowel diseases
This work was supported by institutional funds of the Division of Digestive Diseases at the University of California, Los Angeles for projects relevant to the UCLA Center for Inflammatory Bowel Diseases.
Compliance with ethical standards
Conflict of interest
WKD, DN, NED, EK, and MGHO declare no conflicts of interest. DWH has a patent Value-Based Health Care Management Systems and Methods issued to UCLA.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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