Does System Structure Affect Organizational Application of PREMs: A Comparative Evaluation of 5 Countries

Patient-reported experience measures (PREMs) are widely used to assess healthcare quality, yet approaches to measurement and data utilization vary significantly across countries. This meta-narrative review examines how health system structure, regulatory context, and market dynamics shape the collection, reporting, and application of PREM data in Canada, Germany, the Netherlands, the United Kingdom, and the United States. Using RAMESES guidelines, we searched PubMed, Web of Science, and ABI/INFORM and identified 58 peer-reviewed studies, primarily from the U.S. and U.K. Studies most frequently examined the relationship between hospital characteristics and patient experience, measurement tools, and quality improvement efforts. Our findings suggest that a country's health system structure influences the collection and reporting of PREM data. However, greater efforts are needed to translate data into actionable quality improvement activities. To advance patient-centered care, future research should examine how hospital leaders and providers interpret and act on PREM data within specific organizational and policy contexts.