Abstract
INTRODUCTION: Improving patient-centered outcomes is a core aim of value-based healthcare (VBHC). Integrating patient-reported outcome and experience measures (PROMs/PREMs) into clinical quality registries may provide insight into health-related quality of life (HRQL) and variation in care. We piloted PROMs/PREMs collection in an Australian Lung Cancer Registry to evaluate associations between HRQL, clinical outcomes and treatment value. METHODS: Individuals newly diagnosed with lung cancer across five metropolitan health services were invited to complete electronic PROMs (EORTC QLQ-C30 and QLQ-LC29) and PREMs at baseline and follow-up. Preference-based utilities (QLU-C10D) and quality-adjusted life-years (QALYs) were derived and linked with registry clinical data. Stage-specific Australian health system cost estimates for guideline concordant treatment (GCT) provided context for value-based reporting. Multivariable regression examined associations between HRQL and clinical variables. RESULTS: Baseline PROMs/PREMs were completed by 241/490 (49%) participants. HRQL was associated with cancer stage, ECOG performance status ≥ 2, comorbidities, weight loss, and receipt of GCT (p = 0.041). HRQL remained stable among ongoing respondents over time. Estimated health system costs increased with advancing stage, while earlier stage disease was associated with better HRQL and survival. A registry-level VBHC dashboard integrating HRQL, patient experience, clinical quality indicators and cost context was developed to support health service performance review. CONCLUSIONS: PROMs/PREMs linked with clinical and cost data provided meaningful insight into patient-centered outcomes and drivers of value in lung cancer care. This VBHC framework highlights the importance of early diagnosis and access to evidence-based treatment and offers a scalable approach to support patient-centered quality improvement at the health system level.