Patient reported outcomes in spine surgery

In recent years, there has been a gradual movement in healthcare towards increasing the value of the care provided to patients. To this end, the importance of patient reported outcome measurement has gained in prevalence and in importance in the emerging reimbursement model that hinges more on the quality of the care provided, rather than the amount or volume of care (Huskisson, Lancet 2(7889):1127-1131, 1974). This patient-centered system focuses on the value that an individual receives from a surgical intervention as defined as the quality of care and patient experience per unit of cost (Huskisson, Lancet 2(7889):1127-1131, 1974). Quality measurement value is an inherently difficult task as this definition may vary based on the perspective taken (i.e. patient, hospital, physician, etc.). PRO have the objective of focusing on what patients find valuable when undergoing an intervention rather than focusing on what clinicians determine to be favorable outcomes. PRO also aim to quantify health status from the patient's viewpoint without interpretation of responses by the clinician (Huskisson, Lancet 2(7889):1127-1131, 1974). These tools can be extremely valuable when measuring patient's progress as they focus on the aspects that motivated a patient to pursue an intervention. This chapter focuses on PRO use in the field of spine surgery.