Outcomes management and resource allocation : how should quality of life be measured? Hadorn, David C., 1952-
The relentless increase in health care expenses, coupled with persistent concerns about the quality and appropriateness of medical services, has brought increasing pressure to bear on researchers to develop more efficient strategies for determining "what works" in medicine. Several years ago, Paul Ellwood recommended that society arrange to regularly collect information concerning the health-related quality of life (HRQOL) of patients with medical problems and conditions. Coupled with demographic, clinical, and treatment data, this HRQOL outcome information would permit researchers to determine which services provide significant benefit to which types of patients. For many reasons, Ellwood's vision of large-scale "outcomes management" programs has not come to pass. Probably the most significant impediment has been the absence of a very brief, generic HRQOL survey instrument which is calibrated according to empirically derived values and preferences. This discussion paper describes an effort to create and test such a questionnaire.
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