College of Business and Social Sciences, Aston University, Birmingham, UK.
School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
Semin Nephrol. 2024 May-Jul;44(3-4):151553. doi: 10.1016/j.semnephrol.2024.151553. Epub 2024 Aug 29.
Risk, prevalence, management, and outcomes in chronic kidney disease (CKD) are influenced by social and broader determinants of health. Consequently, there are wide-ranging kidney health inequities. As patients are key stakeholders, their perspectives on the care they receive and on health status are central in guiding health system improvement, particularly to reduce the impact of disadvantage. Patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) are important self-report tools in quality improvement, acting to guide initatives aimed at enhancing access to timely and relevant support. However, the extent to which PREMs and PROMs address the reduction of kidney health inequities is unclear. The aim of this review is to summarize how PREMs and PROMs are designed and implemented, highlighting key dimensions that are integral to health equity-oriented quality improvement in kidney care. There are several problems yet to be overcome so that such tools do not unintentionally reproduce kidney health gaps. Inclusive generation of the scope of tools, transparent reporting on attributes of patients who engage, and embedding PREMs and PROMs within a framework of value-based quality improvement is fundamental to their impact as part of equitable health system transformation.
慢性肾脏病（CKD）的风险、患病率、管理和结局受健康的社会和更广泛决定因素的影响。因此，存在广泛的肾脏健康不平等现象。由于患者是主要利益相关者，他们对所接受的护理以及健康状况的看法对于指导卫生系统的改善至关重要，尤其是为了减少不利因素的影响。患者报告的体验测量（PROMs）和患者报告的结果测量（PROMs）是质量改进中的重要自我报告工具，有助于指导旨在增强及时和相关支持的获取的倡议。然而，PREMs 和 PROMs 在多大程度上解决了减少肾脏健康不平等的问题尚不清楚。本综述的目的是总结 PREMs 和 PROMs 的设计和实施方式，强调与肾脏保健中以公平为导向的质量改进相关的关键维度。仍有几个问题需要克服，以免这些工具无意中加剧肾脏健康差距。包容性地确定工具的范围、透明地报告参与的患者的特征，并将 PREMs 和 PROMs 嵌入基于价值的质量改进框架中，是它们作为公平的卫生系统转型的一部分产生影响的基础。
