Evaluation Of Health Services Research Articles

Collective oral health care at Xukuru do Ororubá Indigenous Territory (Pesqueira, Brazil) in 2018

Abstract Background Primary oral health care services are responsible for performing collective actions, in order to prevent diseases and promote health through education. Brazilian indigenous populations, especially from the Northeast Region, suffer from insufficient access to oral health services. From this perspective, this study aims to verify the performance of oral health collective actions indicators in the territory of the Xukuru do Ororubá indigenous ethnic group (Pesqueira, Brazil) in 2018. Methods An observational and ecological study. Secondary data for 2018 were extracted from the Indigenous Health Care Information System, part of the Brazilian Unified Health System (SUS). Performance of collective oral procedures conducted by the oral health teams in the Xukuru territory was analyzed through indicators applied for the evaluation of oral health actions and services related to primary care. Results There was an average monthly coverage of the collective supervised toothbrushing (CST) of 47.8% for the entire Xukuru territory. The average monthly coverage of the collective topical fluoride application (CTFA) was 2.8%. There was an annual average of 6.2 collective dental procedures (CDP) per capita. Conclusions Less than half of the population participated in CST actions. CTFA proved to be almost nonexistent, with poor coverage for the general territory population. The annual average of CDP was satisfactory which may, in general terms, demonstrate greater concern with preventive measures. However, it appears that such average gains strength due to the volume of health education actions, which is part of the indicator sum. Analyzing the low coverage of CST and CTFA in isolation, a reality of low access to fluoride in this indigenous population can be seen. Results points to the need for greater provision of collective actions in the indigenous territory studied, aiming at strengthening the prevention of diseases and/or aggravations of oral health, in all life cycles. Key messages Measurement of the performance of oral health teams regarding the collective oral health actions in the territory of the Xukuru do Ororubá ethnic group. Analysis of the indigenous oral health stored data quality, aiming to offer support for system management decision making and to the services organization improvement.

Resin-Bonded Fixed Dental Prostheses with Zirconia Ceramic Single Retainers Show High Survival Rates and Minimal Tissue Changes After a Mean of 10 Years of Service.

To assess the clinical outcomes of single-retainer resin-bonded fixed dental prostheses (RBFDPs) and the profilometric changes of pontic sites after a mean of 10 years in function. Ten patients (mean age 32.4 years) who had received an RBFDP replacing a single anterior tooth were recalled after 10 years. Five patients had received a subepithelial connective tissue graft (SCTG) at the pontic site. The clinical assessment comprised the following parameters: probing depth, bleeding on probing, modified plaque control record, gingival recession, measurement of the width of keratinized mucosa, and intraoral photographs and radiographs. The modified criteria of the United States Public Health Services evaluation system were applied. Additionally, patient satisfaction was recorded. Data were analyzed descriptively, and the 10-year RBFDP survival rates were calculated using Kaplan-Meier analysis. The RBFDP survival rate after a mean follow-up of 10.0 years (range 7.4 to 13.3 years) was 100%. Neither technical failures nor biologic complications were observed. All abutment teeth remained vital, and no secondary caries were detected. Between baseline and follow-up examinations, the profilometric changes at the pontic sites were minimal, exhibiting a loss of -0.03 ± 0.10 mm (no SCTG) and 0.00 ± 0.37 mm (SCTG). The present study exhibited high survival rates and low complication rates of the restorations, as well as excellent profilometric stability of the pontic sites over 10 years. The use of an RBFDP is a viable long-term treatment option for replacing a single anterior tooth.

Satisfação de usuários das unidades de saúde em Coari, Amazonas

Resumo Este trabalho analisou a qualidade da atenção em unidades básicas de saúde de Coari, Amazonas, Brasil. Trata-se de estudo descritivo, quantitativo, de caráter avaliativo, que utilizou questionário validado do Programa Nacional de Avaliação de Serviços de Saúde de 2015. Os dados foram coletados em três unidades, no segundo semestre de 2016. Os resultados apontam que a maioria dos entrevistados era do sexo feminino, casada, com 40 anos de idade ou mais, autodeclarada parda, com ensino médio completo, moradora da área urbana e de baixa renda. O atendimento na recepção foi considerado bom, mas os usuários se mostraram insatisfeitos com a disponibilidade de medicamentos. Na avaliação da limpeza do ambiente, as porcentagens ficaram entre bom e regular, e a estrutura física dos estabelecimentos de saúde foi considerada boa.

Heart failure hospitalizations in persons with and without diabetes in an Italian region: 2008-2018

Abstract Background Hospitalization rate for heart failure (HF) is considered a prevention quality indicator and it is used as a tool to evaluate health services quality. This study aims to assess time trends in HF hospitalizations in a region of Southern Italy, focusing on diabetes mellitus as comorbidity. Methods Data were collected from hospital discharge records. All patients aged 18 or over hospitalized for HF in Abruzzo between 2008 and 2018 were selected, either with or without a diagnostic code of diabetes. Admissions for cardiac procedures were excluded. For each year, gender- and age-adjusted standardized hospitalization rates were calculated. Predictors of HF admissions were estimated by a multivariable regression model. Results Over the study period, 60,737 HF admissions occurred, 34,518 of which among people aged more than 65 (56.8%). A total of 15,424 hospitalizations were performed among diabetic patients (25.4%). The overall age- and gender-adjusted HF hospitalization rate declined substantially from 2008 to 2018 (-12.1%). Diabetes (adjOR 2.48; 95%CI 2.41-2.55), myocardial infarction (adjOR 3.92; 95%CI 3.70-4.14), peripheral vascular disease (adjOR 2.30; 95%CI 2.16-2.44), chronic obstructive pulmonary disease (adjOR 3.97; 95%CI 3.86-4.09) and renal disease (adjOR 5.61; 95%CI 5.44-5.78) were factors associated to an increased risk of HF hospitalization. Although HF admission rates remained higher, a significant reduction was highlighted among diabetic patients (-34.7%). Instead, time trend was nearly stable among persons without diabetes (+2.7%). Conclusions This study has shown a decline in HF hospitalization rate over the period considered, particularly among diabetic patients. HF hospitalization may be potentially avoided with good outpatient care. As the causes for HF admissions may include poor quality of care or problems accessing care, it is worthwhile to identify the triggering factors and the potential targets for an early intervention. Key messages A reduction of HF admissions was observed only among diabetics and not among people without diabetes. As the HF hospitalizations are potentially preventable, the knowledge of the epidemiology is crucial for management of preventive health care.

Do all patients with implantable cardioverter defibrillator need a generator change? A health service evaluation of patients who underwent generator changes from a single tertiary center

BackgroundThe patient characteristics, therapy received and outcomes after one or more implantable cardioverter defibrillator (ICD) generator changes from contemporary practice is not well known. MethodsWe conducted a health service evaluation of patients who underwent ICD implantation and generator change. Patients who had generator changes from February 2016 to October 2019 were identified from our database and electronic records were reviewed for patient characteristics, number of generator changes, receipt of therapy and death. ResultsOur database included 88 patients with a generator change. A total of 22 patients (25.0%) received dual chamber ICD, 10 patients (11.4%) received single chamber ICD, 54 patients (61.3%) received cardiac resynchronization therapy defibrillator and 2 patients (2.3%) received subcutaneous ICD. A second generator change occurred in 18 patients and a third generator changes was performed in 6 patients. There were 29 deaths and a follow up period of 9.4 ± 2.9 years. From implant to initial generator change 39 patients had appropriate antitachycardia pacing (ATP), 6 patient had inappropriate ATP, 29 patients had appropriate shocks and 5 patients had an inappropriate shock. Between the 1st and 2nd generator change and the 2nd and 3rd there were no cases of inappropriate ATP or shock. Overall, 42 patients out of the 88 had appropriate therapy (47.7%) and 7 patients had inappropriate therapy (8.0%). ConclusionsMost patients with ICDs do not receive therapy and a minority have inappropriate therapy which typically occur before the first generator change as we observed no inappropriate therapy beyond the first generator change.

Avaliação dos serviços de Atenção Primária à Saúde: estudo das tendências em teses brasileiras

Este estudo buscou delinear e analisar as tendências nas pesquisas brasileiras, referente à avaliação dos serviços de Atenção Primária à Saúde, com base nos resumos das teses realizadas nos Programas de Pós-Graduação Brasileiros, desde o ano de 2014 até 2018. Trata-se de uma revisão narrativa com busca realizada no Banco de Teses e Dissertações da Coordenação de Aperfeiçoamento Pessoal de Nível Superior, no mês de junho de 2018 combinando os descritores avaliação em saúde; avaliação em serviços de saúde; Atenção Primária à Saúde e Atenção Básica. As palavras-chave foram selecionadas com base nos Descritores em Ciências da Saúde. O corpus documental contou com 25 resumos de teses, que evidenciaram maiores produções advindas da região Sudeste do Brasil. A utilização majoritária da abordagem quantitativa, traz uma lacuna quanto aos métodos utilizados. Autores consagrados em relação a avaliação de serviços de saúde foram identificados em uma grande parcela das teses. Os resultados foram distribuídos em frequências absoluta (n) e relativa (%), e analisados pela convergência de seus resultados. Por fim, a avaliação na APS contribui para a construção do conhecimento científico, pois é capaz de disponibilizar importantes informações que beneficiam a tomada de decisões de gestores, profissionais e órgãos consultivos. Sugere-se, assim, que novas investigações sobre tendências sejam realizadas no âmbito da avaliação em APS.

Morbimortalidade por doenças oncohematológicas no Brasil entre 2002 e 2016

Objetivo: Analisar a tendência temporal de morbimortalidade por doenças oncohematológicas no Brasil, entre 2002 e 2016. Métodos: Estudo descritivo de série temporal. Os dados foram extraídos dos sistemas nacionais de informação de Mortalidade e Internações Hospitalares, no período de 2002 a 2016, analisados no Excel e software STATA. Resultados: De modo geral, observou-se uma tendência crescente nas taxas de mortalidade e morbidade hospitalar por doenças oncohematológicas no Brasil entre 2002 e 2016. Para os óbitos, houve incremento anual de 0.04 óbitos/ano por Leucemias, de 0.03/ano por Linfomas e de 0.04/ano por Mieloma, estatisticamente significante (P=0.000). O número total de homens falecidos por essas doenças foi superior ao de mulheres e as taxas de óbitos foram, para ambos os sexos, crescentes com a idade. As maiores taxas de hospitalização foram encontradas nos idosos, com maior proporção de atendimentos em caráter de urgência e diagnóstico principal de leucemias. As regiões Sul e Sudeste concentram quase 70% das mortes e das internações, porém houve um incremento importante nessas taxas no Nordeste. Conclusão: Os dados mostram o perfil das mortes e hospitalizações causadas por doenças oncohematológicas, sua distribuição regional e reafirmam a sua importância para a avaliação dos serviços de saúde em oncologia.

Assessment of users’ satisfaction in physiotherapy service

Introduction: Satisfaction of the health service user involves multiple factors and dimensions beyond the eminently clinical setting and is inserted in the process of evaluation of health services. It is known that the patient as a source of opinions and suggestions, assists in the process of improving the services offered. Objective: The aim of this study was to evaluate the satisfaction of patients followed in Physical Therapy. Method: It is a cross-sectional descriptive observational research with quantitative and qualitative approach. Two questionnaires (MedRisk and instrument for measuring patient satisfaction with physical therapy in the public health system) were applied in 100 patients. Dimensions were evaluated related to therapist/patient relationship, consultation marking, physical environment, access physical structure and global items. Results: The sample was characterized by the predominance of female users, school graduated and with family income between one and three minimum wages. Most were answered in orthopedics, neurology and rheumatology. 45 objective questions were applied and 42 prevailed at the maximum score. Conclusion: Through the analysis, it was found that the patients mostly were satisfied with the service offered.

Are parents\u2019 geographical origin associated with their evaluation of child and adolescent mental health services? Results from a national survey in Norway

The objective was to assess the association between parents’ geographical origin and their evaluation of outpatient child and adolescent mental health services (CAMHS). Data were collected in a national parent’s experience survey of all outpatient CAMHS in Norway in 2017. Following exclusions, 16,143 parents were part of the study, of which 5932 responded (36.1%). Diagnosis and global psychosocial functional level were collected from the National Patient Register. Multilevel regression was used to assess the association between parents’ geographical origin and parent evaluation of the outpatient CAMHS on ten indicators. Sentiment and content analysis was conducted on open-ended comments from parents. The estimated regression coefficients showed that parents born in Eastern Europe scored the services significantly poorer than parents born in Norway on outcome of treatment (− 7.73, p < 0.01), general satisfaction (− 5.53, p < 0.05), ease of getting in contact with health personnel outside of scheduled appointments (− 17.04, p < 0.001), and knowledge of the services that the child has received at the service (− 10.63, p < 0.001). Parents born in Asia/Africa/South America scored the services similar as Norwegian parents on eight of ten indicators, better on one (waiting time) and poorer on one (ease of getting in contact). Sentiment analysis showed that 54% of the comments from parents born in Eastern Europe were negative, compared to 42% for the Norwegian group and 36% for Asia/Africa/South America. The parents’ evaluation of the outpatient CAMHS were partly associated with their geographical origin, with parents born in Eastern Europe reporting poorer experiences than parents born in Norway.

Identifying and managing osteoporosis before and after COVID-19: rise of the remote consultation?

SummaryThe COVID-19 pandemic is influencing methods of healthcare delivery. In this short review, we discuss the evidence for remote healthcare delivery in the context of osteoporosis.IntroductionThe COVID-19 pandemic has undoubtedly had, and will continue to have, a significant impact on the lives of people living with, and at risk of, osteoporosis and those caring for them. With osteoporosis outpatient and Fracture Liaison Services on pause, healthcare organisations have already moved to delivering new and follow-up consultations remotely, where staffing permits, by telephone or video.MethodsIn this review, we consider different models of remote care delivery, the evidence for their use, and the possible implications of COVID-19 on osteoporosis services.ResultsTelemedicine is a global term used to describe any use of telecommunication systems to deliver healthcare from a distance and encompasses a range of different scenarios from remote clinical data transfer to remote clinician-patient interactions. Across a range of conditions and contexts, there remains unclear evidence on the acceptability of telemedicine and the effect on healthcare costs. Within the context of osteoporosis management, there is some limited evidence to suggest telemedicine approaches are acceptable to patients but unclear evidence on whether telemedicine approaches support informed drug adherence. Gaps in the evidence pertain to the acceptability and benefits of using telemedicine in populations with hearing, cognitive, or visual impairments and in those with limited health literacy.ConclusionThere is an urgent need for further health service evaluation and research to address the impact of remote healthcare delivery during COVID-19 outbreak on patient care, and in the longer term, to identify acceptability and cost- and clinical-effectiveness of remote care delivery on outcomes of relevance to people living with osteoporosis.

Consumer engagement in health services in Queensland, Australia: A qualitative study about perspectives of engaged consumers.

Successive health policies demonstrate unwavering commitment to partnering with consumers and communities. However, engaging consumers is complex and replete with priorities, perspectives and values that are firmly held, virtuous and different. In the context of political imperatives and different approaches to partnering with consumers in health services, we sought to explore consumers' experiences of engagement in public, private, primary care and non-government health services in Queensland, Australia. Participants identified themselves as consumers of health services and were currently, or had previously been, involved in planning, designing, delivering, monitoring and/or evaluating health services; were aged over 18 and consented to being involved. This qualitative study used semi-structured individual interviews to collect data which were analysed thematically. Four themes were identified, (a) authentic engagement and representation: asking, listening and acknowledging; (b) a continuum of consumer expertise; (c) contested engagement: transgressing health services thresholds of tolerance and (d) creating value for consumers and health services: reciprocity, trust, respect and remuneration. Findings demonstrated that 'rules of engagement' exist between consumers and staff employed in clinical, managerial, executive and administrative positions within health services in response to a legislated requirement that health services partner with consumers. The rules of consumer engagement centred on authenticity, transparency, expertise and individual capacity to transcend personal experience. If health services and the broader public are to fully benefit from safety and quality advances proposed by partnering with consumers, then it is essential that areas of contestation are identified and addressed.

Taking care of our future doctors: a service evaluation of a medical student mental health service

BackgroundStudies suggest medical students experience high levels of mental distress during training but are less likely, than other students, to access care due to stigma and concerns regarding career progression. In response, The School of Clinical Medicine, University of Cambridge supported the development of the ‘Clinical Student Mental Health Service’ to provide specialist input for this vulnerable group. This study evaluates the efficiency and effectiveness of this service.MethodsUsing mixed-methods, cross-sectional analysis of validated psychiatric rating scales and qualitative feedback, 89 responses were analysed from 143 clinical students referred, between 2015 and 2019. The care pathway included initial review by a psychiatrist, who triaged students to psychologists delivering therapies including: Cognitive Behavioural Therapy, Interpersonal Therapy, Eye Movement Desensitization Reprocessing Therapy or Cognitive Analytic Therapy.Efficiency was assessed by waiting times for psychiatry and psychology interventions, and number of sessions. Academic outcomes included school intermission and graduation. Clinical effectiveness was analysed by measuring global distress, depression, anxiety, functioning and suicidal risk. Pre/post intervention changes were captured using t-test and McNemar test with thematic analysis of qualitative feedback.ResultsReferral rates increased from 3.93% (22/560) in 2015 to 6.74% (45/668) in 2018. Median waiting times for initial psychiatric assessment and start of therapy was 26 and 33 days, respectively. All graduating students moved on to work as junior doctors.Levels of distress, (t = 7.73, p < 0.001, df = 31), depression (t = 7.26, p < 0.001, df = 34) anxiety (Z = − 4.63, p < 0.001) and suicide risk (Z = − 3.89, p < 0.001) were significantly reduced. Participant’s functioning was significantly improved (p < 0.001, 99.5% CI 4.55 to 14.62). Feedback indicated high satisfaction with the rapid access and flexibility of the service and the team clinicians.ConclusionsA significant proportion of medical students attending the service scored highly on validated rating scales measuring emotional distress, suicidality and mental illness. Reassuringly they benefitted from timely specialist mental health input, showing improvements in mental well-being and improved functioning. The development and design of this service might serve as an exemplar for medical schools developing similar support for their students.

When all else fails: The (mis)use of qualitative research in the evaluation of complex interventions.

Qualitative research has been promoted as an important component of the evaluation of complex interventions to support the scale up and spread of health service interventions, but is currently not being maximized in practice. We aim to identify and explore the sociocultural and structural factors that impact the uses (and misuses) of qualitative research in the evaluation of complex health services interventions. We conducted a qualitative analysis of data collected in a multiple case study of the evaluation and scale up and spread of three health service intervention. Our findings demonstrate the challenges of meaningfully integrating qualitative research in evaluation programmes lead by clinicians with limited qualitative expertise and operating within an environment dominated by biomedical research, even with methodological support. Based on these findings we encourage ongoing engagement of qualitative researchers in evaluation programmes to begin to refine our methodological understanding, while also suggesting changes to medical education and evaluation funding models to create fertile environments for interdisciplinary collaborations.

Evde Sağlık Hizmetlerinin Araştırılması ve Hasta ve Hasta Yakınlarının Beklentileri: Bakırköy'de Bir Araştırma Örneği

Aim: The aim of this study is to examine the expectations and demands of patients and their relatives' in-home health care. In the scope of the study, narrow area as the study was being carried out in the Bakirkoy district of Istanbul province.Method: In the scope of the study, questionnaires were distributed to 83 people in Istanbul who were satisfied with home health care services, but 70 people were returned. The analysis was conducted on 70 people. The research is a descriptive survey model. A questionnaire was used as a data collection tool. The questionnaire forms consist of questions about demographic and home health service evaluation scale. Results: When the opinions of the patients and their relatives were evaluated in terms of home care services, the mean values of all expressions in the home health service evaluation questionnaire were over 4. Conclusion: This indicates that patients who are receiving home care services and their relatives have positive perceptions about home care services. The satisfaction of the patients and their relatives are very high for home care services.

The 11th Australian Rural and Remote Mental Health Symposium Communiqué.

The 11th Australian Rural and Remote Mental Health Symposium Communiqué.

Utilisation of the PRECEDE-PROCEED model in community pharmacy for health needs assessment: A narrative review.

Health needs assessment tools such as the PRECEDE-PROCEED model (PPM) identify the key health concerns of communities, and may increase the capacity for community pharmacies to address these needs. A narrative review was conducted to investigate to what extent the PPM has been used to guide pharmacy service development and evaluation. A systematic search of six databases was conducted for peer-reviewed papers published from January 2000 to August 2019 that described the application of the PPM within the community pharmacy context. Search terms included variations of the following: 'pharmacists', 'precede proceed', 'pharmaceutical services', and 'community pharmacies'. Data extracted and analysed included study design, objectives, population, utilisation of the PPM, and outcomes. Fourteen eligible papers were identified, most of which were cohort or cross-sectional studies and utilised at least one element of the PPM to design or evaluate interventions that targeted either patient behaviours or pharmacist behaviours, or evaluated population health needs or programs. The range of behaviours assessed was limited to patient medication adherence, and billing behaviours, readiness for expanded scope of practice, and communication for pharmacists. None of the studies prioritised community health needs, actively engaged all relevant stakeholders, or utilised every element of the PPM. The PPM has been underutilised in community pharmacy research and represents an effective method for the assessment of health priorities for communities and the development and evaluation of health services targeted at addressing these priorities. Further research needs to demonstrate how key health needs assessment principles such as stakeholder engagement and a population-centred approach can influence effective health service delivery.

Evaluating health service coverage in Ghana’s Volta Region using a modified Tanahashi model

ABSTRACT Background: The United Nations 2030 Sustainable Development Goals have reaffirmed the international community’s commitment to maternal, newborn, and child health, with further investments in achieving quality essential service coverage and financial protection for all. Objective: Using a modified version of the 1978 Tanahashi model as an analytical framework for measuring and assessing health service coverage, this paper aims to examine the system of care at the community level in Ghana’s Volta Region to highlight the continued reforms needed to achieve Universal Health Coverage. Methods: The Tanahashi model evaluates health system coverage through five key measures that reflect different stages along the service provision continuum: availability of services; accessibility; initial contact with the health system; continued utilization; and quality coverage. Data from cross-sectional household and health facility surveys were used in this study. Immunization and antenatal care services were selected as tracer interventions to serve as proxies to assess systems bottlenecks. Results: Financial access and quality coverage were identified as the biggest bottlenecks for both tracer indicators. Financial accessibility, measured by enrollment in Ghana’s National Health Insurance Scheme was poor with 16.94% presenting valid membership cards. Childhood immunization was high but dropped modestly from 93.8% at initial contact to 76.7% quality coverage. For antenatal care, estimates ranged from 65.9% at initial visit to 25.1% quality coverage. Conclusion: Results highlight the difficulty in achieving high levels of quality service coverage and the large variations that exist within services provided at the primary care level. While vertical investments have been prioritized to benefit specific health services, a comprehensive systems approach to primary health care needs to be further strengthened to reach Ghana’s Universal Health Coverage objectives.

Is a Decentralised Health Policy Associated With Better Self-rated Health and Health Services Evaluation? A Comparative Study of European Countries.

Background: While decentralisation has come to be a major policy strategy in many healthcare systems, there is still insufficient evidence about its impact. Most studies have been of developing countries, and they have provided mixed results. This study is the first to test the relevance of political decentralisation across European countries, thus meeting the demand for more studies of decentralisation in developed countries, and building on an indicator of decentralisation reflecting the allocation of authority for both health policy tasks and health policy areas. Methods: As indicators of health system outcome, we employed 2 measures that have not previously been investigated in the context of decentralisation: self-rated health and satisfaction with healthcare system. Using multilevel modelling and controlling for individual-level demographic and socioeconomic variables, the paper utilised the 2014 (7th) and 2016 (8th) round of the European Social Survey (ESS), including more than 70 000 individuals from 20 countries. Results: The results suggest that decentralisation has a positive and significant association with health system satisfaction, but not with self-rated health. Of the different operationalisations, decentralised healthcare provision had the strongest association with health system satisfaction. Conclusions: Our study fails to provide clear support for decentralised health systems. There is a need for more research on the impact of such reforms in order to provide policy-makers with knowledge of desirable governance, organisational designs, management and incentives in healthcare.

Critical considerations for engaging in inclusive health research with individuals with intellectual disability

Commentary on: Schwartz, AE, Kramer, JM, Cohn ES, et al . That Felt Like Real Engagement: fostering and maintaining inclusive research collaborations with individuals with intellectual disability. Qual Health Res...

Using Patient- and Family-Reported Outcome and Experience Measures Across Transitions of Care for Frail Older Adults Living at Home: A Meta-Narrative Synthesis.

Our aim was to create a "storyline" that provides empirical explanation of stakeholders' perspectives underlying the use of patient- and family-reported outcome and experience measures to inform continuity across transitions in care for frail older adults and their family caregivers living at home. We conducted a meta-narrative synthesis to explore stakeholder perspectives pertaining to use of patient-reported outcome and experience measures (PROMs and PREMs) across micro (patients, family caregivers, and healthcare providers), meso (organizational managers/executives/programs), and macro (decision-/policy-makers) levels in healthcare. Systematic searches identified 9,942 citations of which 40 were included based on full-text screening. PROMs and PREMS (54 PROMs; 4 PREMs; 1 with PROM and PREM elements; 6 unspecified PROMs) were rarely used to inform continuity across transitions of care and were typically used independently, rarely together (n = 3). Two overarching traditions motivated stakeholders' use. The first significant motivation by diverse stakeholders to use PROMs and PREMs was the desire to restore/support independence and care at home, predominantly at a micro-level. The second motivation to using PROMs and PREMs was to evaluate health services, including cost-effectiveness of programs and hospital discharge (planning); this focus was rarely at a macro-level and more often split between micro- and meso-levels of healthcare. The motivations underlying stakeholders' use of these tools were distinct, yet synergistic between the goals of person/family-centered care and healthcare system-level goals aimed at efficient use of health services. There is a missed opportunity here for PROMs and PREMs to be used together to inform continuity across transitions of care.