• Masahiro Akishita, Shinya Ishii, Taro Kojima, Koichi Kozaki, Masafumi Kuzuya, Hidenori Arai, Hiroyuki Arai, Masato Eto, Ryutaro Takahashi, Hidetoshi Endo, Shigeo Horie, Kazuhiko Ezawa, Shuji Kawai, Yozo Takehisa, Hiroshi Mikami, Shogo Takegawa, Akira Morita, Minoru Kamata, Yasuyoshi Ouchi, and Kenji Toba.
• Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. akishita-tky@umin.ac.jp
• J Am Med Dir Assoc. 2013 Jul 1;14(7):479-84.

ObjectivesPhysicians are uncertain about what medical services should be provided to older and/or disabled patients. Better understanding of health outcome prioritization among health care providers and recipients may help the process of decision- and policy-making. For this purpose, surveys were conducted on priorities of health care outcomes for the elderly.DesignSurvey research.SettingFour groups of health care providers and four groups of health care recipients.ParticipantsA total of 2512 health care providers and 4277 recipients.MeasurementsQuestionnaires were sent to more than 8000 health care providers and more than 9000 health care recipients: geriatricians, physicians who commonly see older patients or work in long term care facilities, staff members and participants in adult day care, patients in outpatient geriatric clinics, family members of patients with dementia, and community-dwelling older adults. The questionnaire asked the subjects to rank 12 measures of health care outcomes.ResultsThe mean response rate was 49%. All health care provider groups considered "improvement of quality of life" the most important. In contrast, in health care recipient groups, "effective treatment of illness," "improvement of physical function," and "reduction of carer burden" were given high priority, whereas "improvement of quality of life" was perceived as less important. All the groups, including health care providers and recipients, ranked "reduction of mortality" the least important, followed by "avoiding institutional care." Stratification analysis showed that the results did not differ by sex, nursing care level, or the existence of relatives who required nursing care, whereas age slightly influenced the order of high-ranked measures.ConclusionPriorities of health care services and their differences between providers and recipients should be taken into account in the health care of older patients and the design of health care policies and research.Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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