Outcome Measures in Medicine

Authored by: Leah McClimans

The Routledge Companion to Philosophy of Medicine

Print publication date:  October  2016
Online publication date:  October  2016

Print ISBN: 9781138846791
eBook ISBN: 9781315720739
Adobe ISBN: 9781317519850


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Outcome measures assess the effects of health care on the health status of patients (Donabedian, 1988). Although the documentation of outcome measures such as mortality has long history, modern outcome assessment was not established until the 1970s as the result of at least three factors (Epstein, 1990; O’Connor and Neumann, 2006). First and perhaps most significant was the perception of variation in clinical processes from doctor to doctor, hospital to hospital, and region to region. This variation raised questions about the quality of health care, and measuring health outcomes was seen as one way to answer these questions (Epstein, 1990; Kassirer, 1993). A second contributing factor was the influence of cost containment on quality. The growth of managed care and the emphasis on efficiency led to concerns about the negative effect this might have on health care quality. Outcomes measures were seen as one way to monitor possible deterioration in the system (Epstein, 1990). Third, heightened competition among insurers also led to the perceived need for outcome measures that provide a metric of value for different health care plans. Although price plays a key role in this competition, buyers were and still are interested in the relative value of the health care they purchase.

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