Barr J T
National Education and Research Center for Outcomes Assessment in Healthcare (NERCOA), Bouvé College of Pharmacy and Health Sciences, Northeastern University, Boston, MA 02115, USA.
J Allied Health. 1995 Winter;24(1):13-28.
The outcomes movement is exemplified by clinical effectiveness studies incorporating patient-centered outcomes measures. Findings from these studies are used to base payment decisions and improve the structure and process of clinical practices. The usefulness of these studies is dependent upon the selection of appropriate outcomes measures. Typically, clinical measures used by health professionals are narrowly focused and assess physiologic, other biomedical, or limited functional dimensions of health. On the other hand, patient-centered outcome measures are more broadly defined and capture health status as perceived by the patient in areas of health identified to be of value to the patient. An introduction to multidimensional general and disease-specific health status measures is presented. Health status and other outcomes assessments should be part of a continuous quality improvement cycle which begins with measuring patient status and developing treatment plans, proceeds to monitoring patient progress, evaluates the clinical effectiveness of the service, and concludes with outcomes information being fed back to improve the structure and process of future health care services before the cycle can begin again.
以纳入以患者为中心的结局指标的临床有效性研究为代表的结局运动。这些研究的结果被用于支付决策，并改善临床实践的结构和流程。这些研究的有用性取决于适当结局指标的选择。通常，卫生专业人员使用的临床指标关注范围狭窄，仅评估健康的生理、其他生物医学或有限的功能维度。另一方面，以患者为中心的结局指标定义更为宽泛，涵盖患者在其认为对自身有价值的健康领域中所感知到的健康状况。本文介绍了多维通用和特定疾病的健康状况指标。健康状况及其他结局评估应成为持续质量改进循环的一部分，该循环始于测量患者状况并制定治疗计划，接着监测患者进展，评估服务的临床有效性，最后将结局信息反馈以改善未来医疗服务的结构和流程，之后循环才能再次开始。
