Do Patient-Important Outcomes Differ by Care Setting? Findings from Semi-Structured Interviews with Individuals with...

Background: Patient-important outcomes (PIOs) reflect patient values and preferences. Prior studies have elicited a variety of PIOs for diabetes. However, no studies have examined whether, or how, PIOs differ across diabetes care settings. The purpose of this study was to compare the frequencies of PIOs derived from patients with diabetes in primary care (PC), acute care (emergency department (ED)), and post-acute care (post-hospital discharge (PHD)) settings within a large delivery system. Methods: This study was an analysis of 89 interviews with patients in PC, ED, and PHD settings. Participants had moderately to poorly controlled diabetes, defined as follows: presented to the ED with a diabetes-related problem, admitted to the hospital for a diabetes-related problem, or had at least two primary care measurements of hemoglobin A1c (HbA1c) > 7.5 in the prior year. A matrix analysis compared the frequencies of participants' PIOs across the three settings. Results: Overall PIO frequencies were similar across care settings. PIOs fell into seven domains; all seven domains and 21 of the 26 PIOs were represented within each of the care settings. The most common PIOs included "be healthy", "eat right", and "reduce or get off medicines". Conclusions: Participants identified similar PIOs in all care settings, indicating that recruitment from one or two care settings may often be sufficient for achieving saturation of PIOs. Furthermore, the results inform our understanding of patient priorities across the care continuum.