Abstract
Introduction
We used patient reported outcome measures (PROMS) to evaluate qualitative and societal outcomes of trauma.
Methods
We collected PROMs data between Sept 2013 and March 2015 for 92 patients with injury severity score (ISS) greater than 9. We enquired regarding return to work, income and socioeconomic status, dignity and satisfaction and the EQ-5D questionnaire.
Results
Return to work
Of patients working at admission 15/58(26%) anticipated returning to work within 14 days of discharge. Work plans at discharge did not correlate with ISS scores overall (r=−0.05, ns), or when stratified by working group. Increased physicality of work showed a trend towards poorer return to work outcomes (not significant in Spearman's rank analysis: r= 0.14, p= 0.32). Income and socioeconomic status: No significant difference was demonstrated between the comparative incomes of patients with the best and worst return to work outcomes (ANOVA n=61, t=0.63, ns). Lowest quartile earners (n=19) were more likely to complete the open questions (79%) than higher income patients (62%). Dignity and satisfaction: Prominent positive themes were: care, staff, professionalism, and communication. Prominent negative themes were: food, ward response time, and communication. %). Patients ‘mostly’ or ‘always’ satisfied with their care did not have significantly different incomes (ANOVA, t=0.13, ns). EQ-5D: Self-rated health status correlated with perceived likelihood of return to work (r=0.25, p=0.0395). Correlation was demonstrated between EQ-5D scores and perceived dignity preservation (r=0.38, p=0.0004), and overall satisfaction (r=0.46, p< 0.0001). There was no correlation between EQ-5D and ISS score.
Conclusion
EQ5D correlated with work plans, dignity, and satisfaction. Planned return to work did not correlate with ISS score or socioeconomic status. Unlike previous studies we demonstrated that lower socioeconomic groups have best engagement with PROMS. This study highlighted the value of qualitative PROMS analysis in leading patient-driven improvements in trauma care.
