Outcome Measurement: The State of the Science
Brenda M. Booth, Ph.D. and G. Richard Smith, M.D.
HSR&D Field Program for Mental Health, Little Rock VA Medical Center; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR; and Center for Outcomes Research and Effectiveness, University of Arkansas for Medical Sciences, Little Rock, AR
An overview of the state of science of patient outcome assessment is presented. The objectives of outcome assessment are to assess patient characteristics, the processes of treatment, and the consequences of routine care in order to monitor and/or improve the outcomes of treatment. Effective patient outcomes assessment is now both feasible to perform and is becoming increasingly valuable to all parties concerned with health care delivery. Providers, payers, and clinicians are becoming increasingly literate and, in some cases, proficient in the science of outcomes assessment. Recent progress of patient outcomes assessment includes the delineation of the domains of outcomes and development of patient/consumer-based assessment scales and indices. Current issues of scientific debate include disorder-specific assessment versus generic assessment, sampling versus assessment of an entire population, and assessment of a tracer condition versus assessment of all conditions. Future challenges include consumer preferences, interpretation and management of assessment results, and technology development. Well-designed research is needed for demonstration projects, technology development and application, and dissemination.
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