Using Outcome Information During Consultation Yields Better Shared Decision Making, Better Patient Experiences, and More Positive Expectations: A Comparative Effectiveness Study

Abstract

Objectives: Value-based healthcare has recently gained recognition. Part of this framework uses the outcome information from daily care. This study evaluated the effects of patients' perceived use of outcome information on shared decision making, patient experiences with healthcare, treatment credibility, and outcome expectations.

Methods: Data were collected from 25 hand surgery and therapy clinics. We created 2 groups based on whether patients indicated that outcome information was used (Outcome Information group) or not (control group) during the clinician consultation. Patients' experiences with healthcare were assessed after the first consultation using a digitally distributed patient-reported experience measure and a questionnaire to measure treatment credibility and expectations. Confounders were controlled for using propensity score matching in a 3:1 ratio. We calculated Cliff's delta as an effect size measure (0.11-0.27 small, 0.28-0.42 medium, and >0.43 large).

Results: After propensity score matching, we included 636 patients in the Outcome Information group and 212 in the control groups, respectively. The Outcome Information group experienced more shared decision making (Cliff's delta 0.33 [0.24-0.40], P < .001) and scored better on all patient-reported experience measure items. Patients in the Outcome Information group had more positive expectations of the treatment outcome (Cliff's delta: 0.21 [0.12-0.29], P < .001) and found their treatment more credible (Cliff's delta: 0.26 [0.18-0.34], P < .001) than those in the control group.

Conclusions: The perceived use of outcome information by patients leads to more shared decision making, better experiences with healthcare, and more positive outcome expectations and treatment credibility. Therefore, we recommend the use of outcome information in daily care to fulfill the promise of value-based healthcare.

Keywords: PROMs; outcome information; patient experience; shared decision making; value based healthcare.