Understanding the use of patient-reported data by health care insurers: A scoping review.
<h4>Background</h4>Patient-reported data are widely used for many purposes by different actors within a health system. However, little is known about the use of such data by health insurers. Our study aims to map the evidence on the use of patient-reported data by health insurers; to exp...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0244546&type=printable |
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| author | Anne Neubert Óscar Brito Fernandes Armin Lucevic Milena Pavlova László Gulácsi Petra Baji Niek Klazinga Dionne Kringos |
| author_facet | Anne Neubert Óscar Brito Fernandes Armin Lucevic Milena Pavlova László Gulácsi Petra Baji Niek Klazinga Dionne Kringos |
| author_sort | Anne Neubert |
| collection | DOAJ |
| description | <h4>Background</h4>Patient-reported data are widely used for many purposes by different actors within a health system. However, little is known about the use of such data by health insurers. Our study aims to map the evidence on the use of patient-reported data by health insurers; to explore how collected patient-reported data are utilized; and to elucidate the motives of why patient-reported data are collected by health insurers.<h4>Methods</h4>The study design is that of a scoping review. In total, 11 databases were searched on. Relevant grey literature was identified through online searches, reference mining and recommendations from experts. Forty-two documents were included. We synthesized the evidence on the uses of patient-reported data by insurers following a structure-process-outcome approach; we also mapped the use and function of those data by a health insurer.<h4>Results</h4>Health insurers use patient-reported data for assurance and improvement of quality of care and value-based health care. The patient-reported data most often collected are those of outcomes, experiences and satisfaction measures; structure indicators are used to a lesser extent and often combined with process indicators. These data are mainly used for the purposes of procurement and purchasing of services, quality assurance, improvement and reporting, and strengthening the involvement of insured people.<h4>Conclusions</h4>The breadth to which insurers use patient-reported data in their business models varies greatly. Some hindering factors to the uptake of such data are the varying and overlapping terminology in use in the field and the limited involvement of insured people in a health insurer's business. Health insurers are advised to be more explicit in regard to the role they want to play within the health system and society at large, and accommodate implications for the use of patient-reported data accordingly. |
| format | Article |
| id | doaj-art-1b5a4da20145447e9d4c2a998dadc75b |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-1b5a4da20145447e9d4c2a998dadc75b2025-02-05T05:33:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011512e024454610.1371/journal.pone.0244546Understanding the use of patient-reported data by health care insurers: A scoping review.Anne NeubertÓscar Brito FernandesArmin LucevicMilena PavlovaLászló GulácsiPetra BajiNiek KlazingaDionne Kringos<h4>Background</h4>Patient-reported data are widely used for many purposes by different actors within a health system. However, little is known about the use of such data by health insurers. Our study aims to map the evidence on the use of patient-reported data by health insurers; to explore how collected patient-reported data are utilized; and to elucidate the motives of why patient-reported data are collected by health insurers.<h4>Methods</h4>The study design is that of a scoping review. In total, 11 databases were searched on. Relevant grey literature was identified through online searches, reference mining and recommendations from experts. Forty-two documents were included. We synthesized the evidence on the uses of patient-reported data by insurers following a structure-process-outcome approach; we also mapped the use and function of those data by a health insurer.<h4>Results</h4>Health insurers use patient-reported data for assurance and improvement of quality of care and value-based health care. The patient-reported data most often collected are those of outcomes, experiences and satisfaction measures; structure indicators are used to a lesser extent and often combined with process indicators. These data are mainly used for the purposes of procurement and purchasing of services, quality assurance, improvement and reporting, and strengthening the involvement of insured people.<h4>Conclusions</h4>The breadth to which insurers use patient-reported data in their business models varies greatly. Some hindering factors to the uptake of such data are the varying and overlapping terminology in use in the field and the limited involvement of insured people in a health insurer's business. Health insurers are advised to be more explicit in regard to the role they want to play within the health system and society at large, and accommodate implications for the use of patient-reported data accordingly.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0244546&type=printable |
| spellingShingle | Anne Neubert Óscar Brito Fernandes Armin Lucevic Milena Pavlova László Gulácsi Petra Baji Niek Klazinga Dionne Kringos Understanding the use of patient-reported data by health care insurers: A scoping review. PLoS ONE |
| title | Understanding the use of patient-reported data by health care insurers: A scoping review. |
| title_full | Understanding the use of patient-reported data by health care insurers: A scoping review. |
| title_fullStr | Understanding the use of patient-reported data by health care insurers: A scoping review. |
| title_full_unstemmed | Understanding the use of patient-reported data by health care insurers: A scoping review. |
| title_short | Understanding the use of patient-reported data by health care insurers: A scoping review. |
| title_sort | understanding the use of patient reported data by health care insurers a scoping review |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0244546&type=printable |
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