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Review
. 2021 Mar;54(2):122-124.
doi: 10.1007/s00391-020-01777-4. Epub 2020 Sep 16.

Patient-reported outcome and experience measures in geriatric emergency medicine

James D van Oppen  1   2 , Jose M Valderas  3 , Nicola J Mackintosh  4 , Simon P Conroy  4   5
Affiliations
Review

Patient-reported outcome and experience measures in geriatric emergency medicine

James D van Oppen et al. Z Gerontol Geriatr. 2021 Mar.

Abstract
in English, German

Older people with frailty and health crises have complex physical and social needs. Modern emergency care systems are fast-flowing, using protocols optimised for single-problem presentations. Systems must incorporate individualised care to best serve people with multiple problems. Healthcare quality is typically appraised with service metrics, such as department length of stay and mortality. Worldwide, patient-reported outcome measures (PROM) and patient-reported experience measures (PREM) are increasingly used in research, service development and performance evaluation, paving the ground for their use to support individual clinical decision-making. The PROMs and PREMs are person-centred metrics, which inform healthcare decisions at the individual level and which at the strategic level drive improvement through comparison of interprovider effectiveness. To date, there is no PROM or PREM specifically developed for older people with frailty and emergency care needs.

Ältere Menschen mit Frailty und Gesundheitskrisen haben komplexe körperliche und soziale Bedürfnisse. Moderne Notfallversorgungssysteme verfügen über schnelle Abläufe und verwenden Protokolle, die für Einzelproblemdarstellungen optimiert sind. Die Systeme müssen eine individualisierte Versorgung umfassen, um Menschen mit multiplen Problemen bestmöglich zu versorgen. Die Qualität der Gesundheitsversorgung wird in der Regel anhand von Leistungskennzahlen wie die Dauer des Aufenthalts in der Abteilung und Mortalität bewertet. Weltweit werden in der Forschung, Leistungsentwicklung und Leistungsevaluierung zunehmend „patient-reported outcome measures“ (PROMs) sowie „patient-reportet experience measures“ (PREMs) verwendet und damit die Grundlage für deren Verwendung zur Unterstützung individueller klinischer Entscheidungen geschaffen. Bei den PROMs und PREMs handelt es sich um personenzentrierte Messgrößen, die auf individueller Ebene die Entscheidungen der Gesundheitsversorgung beeinflussen und auf strategischer Ebene durch den Vergleich der Wirksamkeit zwischen den Leistungserbringern Verbesserungen bewirken. Bis heute gibt es kein PROM oder PREM, das speziell für ältere Menschen mit Gebrechlichkeit und Notfallversorgungsbedarf entwickelt wurde.

Keywords: Comorbidities; Frailty; Length of stay; Outcome; Patient preference.

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References

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    1. Burkett E, Martin-Khan M, Gray L (2017) Quality indicators in the care of older persons in the emergency department: a systematic review of the literature. Australas J Ageing 36:286–298 - DOI

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