Psychometric evaluation of patient-reported experience measures for healthcare quality in hospitalized adults: a systematic review following COSMIN guidelines

To thoroughly review the psychometric features of Patient-Reported Experience Measures (PREMs) used in adult inpatients in general surgical or medical wards. We searched seven databases. Data extraction, quality assessment, measurement property evaluation, and evidence synthesis were conducted in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria. Twenty-three PREMs were assessed in thirty studies. Instruments were divided into reflective, mixed and unclear measurement models. Reflective and mixed instruments, PEQ (Revised) and IEMS, were rated as Category A (strongly recommended), and the others were rated as Category B (weakly recommended). Instruments with unclear measurement models were rated “not currently recommended” due to insufficient evidence. No instruments were found in Category C because no high-quality evidence was found for insufficient measurement properties. The present review highlights a substantial gap between the number of instruments and their psychometric quality. Two instruments have sufficient evidence for cross-sectional application; universal gaps exist in structural validity, cross-cultural validity, measurement error, and responsiveness. Future studies should include extensive patient engagement in item development, adopt modern psychometric methods to confirm the model structure, and provide a specific evaluation of the longitudinal measurement properties in accordance with COSMIN requirements. PROSPERO CRD420251076118, registered 20/06/2025.