Patient-Reported Outcomes (PROMs) and Public Health: Using PROMs for Population-Level Quality Monitoring

Introduction

Patient-centred metrics are increasingly central in evaluating health system performance. Patient-Reported Outcome Measures (PROMs) capture subjective health status and quality of life, extending beyond clinical care to population-level health monitoring. This review examines PROM integration into public health surveillance and quality assessment frameworks, recognising that traditional clinical metrics often overlook the dimensions of health most important to patients and populations.

Methods

This review synthesises the literature on PROMs in population health through a structured critical appraisal. Comprehensive searches across MEDLINE, Web of Science, and CINAHL (2015 onwards) identified peer-reviewed studies on PROM implementation, validation, and utility at population or health system levels. Findings were categorised by PROM type, healthcare settings, health conditions, and public health applications. No new data were generated; analysis relied exclusively on the published literature.

Results

PROMs demonstrate strong validity and reliability for large-scale application; successful implementations exist in national health systems, including England's NHS programme. Significant challenges persist: data standardisation, comparability between PROMs, digital access disparities, and equity concerns. Evidence supports PROMs' utility in monitoring quality, identifying health inequalities, and tracking chronic disease outcomes, yet routine integration into surveillance remains inconsistent globally.

Conclusions

PROMs hold promise in enhancing population-level quality monitoring and informing evidence-based health policy by centring patient perspectives. Widespread implementation faces barriers in standardisation, technology, and equity-sensitive deployment. Priorities include developing harmonised international frameworks, advancing secure digital collection methods, establishing equity-focused guidelines, and integrating PROMs into broader public health surveillance systems.