Improving the response rate of patient-reported outcome measures in an Australian tertiary metropolitan hospital

Abstract

Andy Ho1,2, Christa Purdie1,2, Oren Tirosh,3 Phong Tran3,41Faculty of Medicine, University of Melbourne, Melbourne, VIC, Australia; 2Western Clinical School, Western Health, Footscray, Melbourne, VIC, Australia; 3Department of Orthopaedic Surgery, Western Health, Melbourne, VIC, Australia; 4Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, VIC, AustraliaBackground: The benefits of collecting patient-reported outcome measures (PROMs) for clinical care are widely accepted; however, the collection and response rate remain a significant barrier.Objective: The objective of this study was to assess predictors of successful PROM response rate in an orthopedic outpatient setting at a public tertiary hospital.Method: A prospective cohort study was conducted at a metropolitan hospital assessing the response rate after a number of interventions in the collection of PROMs in the orthopedic outpatient setting. All patients were invited to complete a PROM relevant to their presenting condition. Eight cohorts were studied, all different in the process of collection, the timing of collection and the physical environment of collection. Analysis was completed in Stata v14.1 with collin commands used to assess collinearity. A multiple logistic regression model and a mixed effect logistic regression model were performed and compared. The significance level of p<0.05 was used.Results: During the trial period 2,338 patients were seen. Response rates as high as 81% were seen, which was significantly improved compared with the earliest six cohorts (p<0.01). Being younger; being a new patient; having a longer wait time; having an English-speaking background and being a pre- or post-operative patient were all associated with an increased response rate of PROMs. Gender, the patient’s pathology and the type of PROM did not significantly affect the response rate.Conclusions: The method employed to invite and inform patients of the PROM collection, and the environment in which it is undertaken, significantly alter the response rate in the completion of PROMs. Being younger, being a new patient, having a longer wait time, being English speaking, being a pre-op or post-op patient were all associated with an increase in response rate.Keywords: patient reported outcome measures, PROM, quality of life, QOL, patient outcomes, orthopedics