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What is “Value”? Results of a Survey of Cancer Patients and Providers

  • Global Health Services Research
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

We measured the importance patients with gastrointestinal cancer and health care providers place on treatment outcomes, quality of life, and costs.

Methods

This cross-sectional survey study was conducted between June 1, 2020 and November 30, 2020. We identified surviving patients who had been treated or were anticipating treatment for pancreatic or gastric cancer at our single institution from January 1, 2000 through January 31, 2020. Surveys assessed the importance patients and providers placed on outcomes, well-being, costs, and experiences. Surveys measured how these values had changed over time. We compared the importance patients and providers place on each of the attributes of value.

Results

A total of 383 patients and 164 providers responded. Providers felt experience, emotional well-being, and costs were more important than patients themselves did (all p < 0.05). Patients more commonly reported that survival had become more important to them over time, while providers believed that emotional well-being, experience, and costs had become more important to patients (all p < 0.05). Postoperative patients ranked functional well-being as more important than preoperative patients did (p = 0.031). Patients of lower income and education levels more reported concerns of costs over the course of their care (both p < 0.05). Younger age was associated with concern for direct (r = −0.167, p = 0.004) and indirect costs (r = −0.318, p < 0.001).

Conclusions

Although there are consistencies amongst the views of cancer patients and providers, there remain discordances in the perception of value. Patients’ values differed across their treatment and survivorship course. These data demonstrate the importance of accounting for multistakeholder perspectives in assessments of value in health care.

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Author information

Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, Allegheny Health Network, Pittsburgh, PA, USA

    Casey J. Allen MD

  2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Grace L. Smith MD

  3. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Laura Prakash MD, Naruhiko Ikoma MD & Matthew H. G. Katz MD

  4. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Robert J. Volk PhD

  5. Ascension, St. Louis, MO, USA

    Thomas A. Aloia MD

  6. The Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Vijaya Gottumukkala MD

  7. Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Vijaya Gottumukkala MD

Authors
  1. Casey J. Allen MD
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  2. Grace L. Smith MD
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  3. Laura Prakash MD
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  4. Robert J. Volk PhD
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  5. Naruhiko Ikoma MD
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  6. Thomas A. Aloia MD
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  7. Vijaya Gottumukkala MD
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  8. Matthew H. G. Katz MD
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Contributions

CJA is directly responsible for all aspects of this article. He participated in the concept, collection, analysis, and interpretation of data; drafting and revision of the manuscript. LP participated in the collection, analysis, and interpretation of data; drafting and revision of the manuscript. GLS, RJV, NI, TA, and VG participated as significant collaborators on concept, design, analysis, interpretation, and revision of the manuscript. They were critically important to the intellectual content. MHGK had overall responsibility for the study, including conception and design; analysis and interpretation; drafting and revision of the manuscript; obtaining funding for this project; supervision.

Corresponding author

Correspondence to Matthew H. G. Katz MD.

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The authors declare that they have no conflict of interest.

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Allen, C.J., Smith, G.L., Prakash, L. et al. What is “Value”? Results of a Survey of Cancer Patients and Providers. Ann Surg Oncol 29, 6537–6545 (2022). https://doi.org/10.1245/s10434-022-11534-z

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  • DOI: https://doi.org/10.1245/s10434-022-11534-z

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