Valderas Jose M, Porter Ian, Martin-Delgado Jimmy, Rijken Mieke, de Jong Judith, Groene Oliver, Bloemeke-Cammin Janika, Sunol Rosa, Williams Rachel, Ballester Marta, de Bienassis Katherine, Kendir Candan, Guanais Frederico, de Boer Dolf, van den Berg Michael
Department of Health & Community Sciences, Exeter Collaboration for Academic Primary Care (APEx), University of Exeter, Exeter, UK
Centre for Research in Health Systems Performance, National University of Singapore (NUS), Singapore.
BMJ Qual Saf. 2025 Jul 18;34(8):529-536. doi: 10.1136/bmjqs-2024-017301.
BackgroundThe Organisation for Economic Co-operation and Development (OECD) Patient-Reported Indicator Surveys (PaRIS) initiative aims to support countries in improving care for people living with chronic conditions by collecting information on how people experience the quality and performance of primary and (generalist) ambulatory care services. This paper presents the development of the conceptual framework that underpins the rationale for and the instrumentation of the PaRIS survey.
The guidance of an international expert taskforce and the OECD Health Care Quality Indicators framework (2015) provided initial specifications for the framework. Relevant conceptual models and frameworks were then identified from searches in bibliographic databases (Medline, EMBASE and the Health Management Information Consortium). A draft framework was developed through narrative review. The final version was codeveloped following the participation of an international Patient advisory Panel, an international Technical Advisory Community and online international workshops with patient representatives.
85 conceptual models and frameworks were identified through searches. The final framework maps relationships between the following domains (and subdomains): patient-reported outcomes (symptoms, functioning, self-reported health status, health-related quality of life); patient-reported experiences of care (access, comprehensiveness, continuity, coordination, patient safety, person centeredness, self-management support, trust, overall perceived quality of care); health and care capabilities; health behaviours (physical activity, diet, tobacco and alcohol consumption), sociodemographic characteristics and self-reported chronic conditions; delivery system characteristics (clinic, main healthcare professional); health system, policy and context.
The PaRIS conceptual framework has been developed through a systematic, accountable and inclusive process. It serves as the basis for the development of the indicators and survey instruments as well as for the generation of specific hypotheses to guide the analysis and interpretation of the findings.
背景
经济合作与发展组织（OECD）患者报告指标调查（PaRIS）倡议旨在通过收集人们对初级和（全科）门诊护理服务质量及绩效体验的信息，支持各国改善慢性病患者的护理。本文介绍了支撑PaRIS调查基本原理和工具的概念框架的制定过程。
国际专家工作组的指导意见以及经合组织医疗质量指标框架（2015年）为该框架提供了初始规范。随后通过在书目数据库（Medline、EMBASE和健康管理信息联盟）中检索，确定了相关的概念模型和框架。通过叙述性综述制定了框架草案。最终版本是在国际患者咨询小组、国际技术咨询社区参与以及与患者代表举行的在线国际研讨会之后共同制定的。
通过检索确定了85个概念模型和框架。最终框架描绘了以下领域（及子领域）之间的关系：患者报告的结果（症状、功能、自我报告的健康状况、健康相关生活质量）；患者报告的护理体验（可及性、全面性、连续性、协调性、患者安全、以患者为中心、自我管理支持、信任、总体感知护理质量）；健康和护理能力；健康行为（身体活动、饮食、烟草和酒精消费）、社会人口学特征和自我报告的慢性病；提供系统特征（诊所、主要医疗保健专业人员）；卫生系统、政策和背景。
PaRIS概念框架是通过系统、可问责和包容的过程制定的。它作为指标和调查工具开发的基础，以及生成特定假设以指导研究结果分析和解释的基础。
