Value-based healthcare in fertility care using relevant outcome measures for the full cycle of care leading towards shared decision-making: a retrospective cohort study.

Autor:	Bensink M; Fertility Center, Isala Klinieken, Zwolle, The Netherlands., Volkerink J; Fertility Center, Isala Klinieken, Zwolle, The Netherlands j.volkerink@isala.nl., Teklenburg G; Fertility Center, Isala Klinieken, Zwolle, The Netherlands., van Bavel CCAW; Fertility Center, Isala Klinieken, Zwolle, The Netherlands., Kuchenbecker WKH; Fertility Center, Isala Klinieken, Zwolle, The Netherlands., Cohlen BJ; Fertility Center, Isala Klinieken, Zwolle, The Netherlands., Curfs MHJM; Fertility Center, Isala Klinieken, Zwolle, The Netherlands.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Sep 11; Vol. 13 (9), pp. e074587. Date of Electronic Publication: 2023 Sep 11.
DOI:	10.1136/bmjopen-2023-074587
Abstrakt:	Objective: To determine if the introduction of value-based healthcare (VBHC) in fertility care can help to create realistic expectations in patients resulting in increased patient value, by demonstrating the relevance of defining outcome measures that truly matter to subfertile patients. Design: Retrospective cohort study. Setting: Tertiary fertility centre. Results: Time to pregnancy (TTP) and ongoing pregnancy rate (OPR), as a proxy for the live birth rate, for the full cycle of fertility care, regardless of which and how many treatment cycles performed, were identified as the most relevant medical outcome measures. Outcome measures were incorporated into a digital dashboard by using anonymised and validated patient data from the electronic patient file. We were able to present the TTP and OPR for the population as a whole as well as stratified for age, diagnosis, gravidity and type of gamete source used thereby resulting in a virtual 'patient like me' resembling the individual patient in the consultation room. Conclusion: We have shown that, by applying VBHC principles, relevant outcome measures can be generated and stratified for different patient characteristics, in order to develop a virtual 'patient like me'. This virtual 'patient like me' can be used in the consulting room in the form of a digital dashboard, attributing to create realistic patient expectations. This facilitates healthcare providers and patients in shared decision-making. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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