What health care experiences matter to patients and how can we assign value to them for policy making purposes?

Many aspects of the health care experience matter to patients, but health care policy decisions do not always reflect this fact. Policy decisions about which treatments to fund on the NHS, for example, focus mainly on the consequences of different policy options for people?s health (quite narrowly defined). In part this is because there is a well recognised method for valuing health states (called the Quality Adjusted Life Year or QALY). The QALY can be used to compare the health benefits obtained by funding different types of treatment. There is no similarly well recognised technique for valuing other aspects of health care experience (such as waiting time, continuity of care, having a sense of control, not feeling stigmatised, being respected as a person with a life to get on with). This research project aims to: identify and describe the range of health care experiences that matter to people; consider which of these experience policy makers need to consider the value of; assess the techniques that are currently available for estimating how much value people assign to these experiences; and identify what further research is needed to enable policy makers to take the value of these experience into account when making policy decisions. The researchers will fulfil these aims by studying existing evidence about what health care experiences matter to people and about how these experiences can be valued, and by presenting their initial findings to groups of experienced patient/carer representatives and policy makers for discussion.

This methodological research project is intended to inform decisions about the use and future development of techniques for valuing aspects of health care experience, other than health outcomes, for the purposes of policy decision-making. The first stage of the project is a literature review and interpretive synthesis to identify which aspects of health care experience matter to patients and why, to clarify the conceptualisation of these, and to develop a robust conceptual map of the (putative) relationships between them. This will inform considerations of which ?patient experience factors? policy makers might require quantitative estimates of the value of. The second stage of the project includes (a) a methodological review to identify and appraise techniques for generating quantitative estimates of the worth (value) of ?patient experience factors? and (b) a systematic aggregative synthesis of studies that have used the most rigorous and promising techniques to assign value to key ?patient experience factors?. This will identify what further research is needed (methodological research to refine the valuation techniques and/or applied research to use the techniques to value particular patient experience factors) to facilitate the consideration of ?patient experience factors? in health policy decisions. The provisional findings and recommendations from both stages of the project will be discussed and refined in workshops involving key stakeholders, including experienced patient/carer representatives.