The challenge of health outcomes.

The health outcomes initiative can be seen as another passing phase in health-care management or taken as a serious challenge to the planning, management and evaluation of health services. This paper explores those challenges. Implementation of the health outcomes initiative will require the application of valid, reliable and appropriately sensitive measures, the use of a broad approach to research, development and monitoring in such a way that it is an intrinsic part of service delivery, the adoption of policy and practice that is firmly based on evidence of outcomes, and the development of an approach to research that emphasises generalizability.