[Patient-reported outcomes: the experience of United Kingdom's NHS and suggestions for the Italian NHS]

Abstract

This paper describes the applications of the patient-reported outcome measures, focusing on the National Health Service (NHS) in the United Kingdom. Over the years the use of some related measures has widened, moving from research to clinical practice, and, only recently, to the healthcare quality assessment. The program launched by the United Kingdom Department of Health in April 2009 falls into the latter one, and requires the collection of patient-reported outcome measures for selected surgical procedures (hip or knee replacement, inguinal hernia, varicose veins) within all the health facilities financed by the National Health Service. Several of questionnaires are administered before and after the procedure, thus allowing to assess the health outcomes reported by the patient. From 2009 to 2013, the total number of questionnaires analyzed was high and steadily growing; in the period April 2009-March 2010 184.818 pre-procedure and 134.768 post-procedure questionnaires were completed by the patients and returned, with a 17% and 11% increase, respectively, compared to the previous period (April 2009-March 2010). The analysis of the United Kingdom's experience offers some reflections for the Italian Health Service with regard to some issues, such as the feasibility and the resources, the most appropriate methodology, and the professional culture.