Blog: Achmea Health Outcomes
Health outcome measurement in patients with peripheral artery disease
Health outcomes are the results people care about most when seeking treatment. To date, no standard set of health outcome measures is used to evaluate treatment approaches for patients with peripheral artery disease (PAD). In this study we tested the outcomes survival, limb salvage, and quality of life for patients with PAD in terms of feasibility, validity, and reliability. Demographic factors and baseline health status were collected from clinical and administrative data, including insurance claims data, and were used for case mix analysis.
The retrospective analysis included 1306 critical limb ischemia patients: 56% male, 60% 65-85 years. The overall 1-year survival rate was 78%, varying from 58% to 88% between hospitals. The overall 1-year limb salvage rate was 85%, varying from 76% to 95% between hospitals, after case mix correction. The prospective analysis included 294 patients with intermittent claudication. The overall VascuQol score significantly improved from 4.25 at presentation to 5.11 at follow-up. The increase in VascuQol score after treatment varied from 0.14 to 1.39 between hospitals.
Conclusion is that survival rate, limb salvage rate, and quality of life scores are adequate measures of health outcomes in PAD. We identified the case mix factors required for valid comparisons between care providers. Interestingly, case mix adjustments can be done using readily available administrative data. Universal reporting of standardized measures of health outcomes in patients with PAD is essential to support informed decision-making, improve health care quality, and reduce health care costs.