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An economic valuation technique identified different inpatient care experience as priorities for older Canadians than a traditional approach

  • Logan Trenaman
    Affiliations
    Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada

    Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada

    Centre for Clinical Epidemiology and Evaluation, Vancouver, British Columbia, Canada
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  • Stirling Bryan
    Affiliations
    School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada

    Centre for Clinical Epidemiology and Evaluation, Vancouver, British Columbia, Canada
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  • Lena Cuthbertson
    Affiliations
    British Columbia Office of Patient-Centred Measurement, Ministry of Health/Providence Health Care, Vancouver, British Columbia, Canada
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  • Rick Sawatzky
    Affiliations
    Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada

    School of Nursing, Trinity Western University, Vancouver, British Columbia, Canada
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  • Dawn Stacey
    Affiliations
    School of Nursing, University of Ottawa, Ottawa, Ontario, Canada

    Centre for Practice Changing Research, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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  • Nick Bansback
    Correspondence
    Corresponding author. N. Bansback, Tel.: 1-604–827–5453; fax: 1-604–822–4994.
    Affiliations
    School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada

    Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada

    Centre for Clinical Epidemiology and Evaluation, Vancouver, British Columbia, Canada
    Search for articles by this author

      Abstract

      Objectives

      To (1) estimate the relative value of older adults’ healthcare experiences based on the Canadian Patient Experience Survey for Inpatient Care (CPES-IC) using an economic valuation technique, and (2) compare the results with those of a conventional key-driver analysis of healthcare experiences based on bivariate correlations.

      Study Design and Setting

      An online survey of 1,074 Canadians aged 60 and older who had been hospitalized within five years. Participants completed the CPES-IC and a best-worst scaling (BWS) valuation task. BWS data were analyzed using a conditional logit model. These results were compared to a conventional key-driver analysis that estimates importance through Spearman's correlations between experiences and a global rating of overall experience.

      Results

      The valuation approach found that the three experiences most valued by patients were: that staff seemed informed and up-to-date about their hospital care, doctors explained things in a way that they could understand, and that they got all the information they needed about their care and treatment. Three of the top five most valued experiences from the valuation approach were among the top five in the key driver analysis. However, there were noteworthy differences in rank order.

      Conclusion

      The results of the valuation exercise can inform local and/or system level quality improvement efforts by identifying priorities from an economic evaluation point of view, which are different than those based on a conventional key-driver analysis. Given the degree of uncertainty in estimates both the rank order and confidence intervals should be used to guide decision-making.

      Keywords

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