Patient-Reported Outcomes: Understanding Surgical Efficacy and Quality from the Patient’s Perspective

  • Jessica I. Billig
  • Erika D. Sears
  • Breanna N. Travis
  • Jennifer F. WaljeeEmail author
Health Services Research and Global Oncology


In surgery, quality assessment encourages improved care delivery, better outcomes, and helps determine surgical efficacy. Quality is important from a patient, provider, payer, and policy maker standpoint. However, given the growth of outpatient procedures, expansion of surgical indications to enhance function, and the decline of perioperative morbidity and mortality, many traditional quality metrics, such as mortality, readmissions, and complications, may not fully capture quality. As such, patient-reported outcomes (PROs) can be used to complement the established clinical outcomes and describe surgical efficacy and quality from the patient’s point of view. Generic and disease-specific PRO measures capture health-related quality of life, functional status, and pain. These measures permit a more holistic understanding of how surgery affects different aspects of a patient’s health, augment other clinical outcomes, and are commonly used to determine efficacy in clinical trials. Moreover, our national reimbursement structure is currently evolving to include PROs for certain surgical conditions in measures of quality and with direct linkage to payments. Even so, there continues to be challenges in the implementation of PRO measures in everyday surgical practice, with questions of optimal administration and how to integrate these measures into provider work flow. Despite these challenges, PROs provide vital information regarding surgical efficacy and quality and are critical in the delivery of patient-centered care.



Dr. Jennifer F. Waljee received funding from the American College of Surgeons and the American Foundation for Surgery of the Hand. Dr. Erika D. Sears is supported by Career Development Award Number IK2 HX002592 from the US Department of Veterans Affairs Health Services R&D (HSRD) Service. The content of this article is the sole responsibility of the authors and does not represent the views of the Department of Veterans Affairs or the United States Government.


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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Jessica I. Billig
    • 1
  • Erika D. Sears
    • 2
    • 3
  • Breanna N. Travis
    • 4
  • Jennifer F. Waljee
    • 2
    Email author
  1. 1.VA/National Clinician Scholars Program, VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Section of Plastic SurgeryMichigan MedicineAnn ArborUSA
  2. 2.Section of Plastic SurgeryMichigan MedicineAnn ArborUSA
  3. 3.VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Section of Plastic SurgeryMichigan MedicineAnn ArborUSA
  4. 4.Department of SurgeryMichigan MedicineAnn ArborUSA

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