work for patients. It holds promise, not only for improving the quality of care, but also for identifying unnecessary or wasteful practices that increase health care costs.
This article outlines the possible uses of outcomes assessment in creating and operating a reformed health care system, and key legal implications. But, first, it attempts to define what outcomes assessment is, and to summarize its strengths and limitations.
II. OUTCOMES ASSESSMENT AND ITS PROGENY
Outcomes assessment is one term used to describe research that evaluates medical and health services and procedures. Such research is primarily designed to determine whether particular procedures or services, such as surgical techniques, diagnostic tests, or therapeutic interventions, work as intended; that is, whether they are effective in identifying a source of illness or disability, relieving symptoms of illness, curing a disease, or preventing illness. The term "outcomes" denotes that the focus is on the service's success or failure in producing a desired outcome for the patient. Several other terms are used to mean the same or similar things, "outcomes research" and "technology" assessment being the most common.
Quality assessment or assurance has a broader connotation.(1) It is used in hospital and other health care facility programs to monitor the quality of care provided to patients and ordinarily includes measures of available resources and the process of care, as well as patient outcomes.(2)
Medical practice standards, policies, parameters, or guidelines are more specific statements of what should or should not be done in particular clinical circumstances.(3) Most have been developed by professional specialty organizations for use by practitioners. Increasingly, practice standards use the results of outcomes research in establishing general guidelines for preventing, diagnosing, or treating certain clinical conditions. In fact, many believe that t...