The use of outcome assessment: the clinician's concerns

In the last few years increasing attention has been paid to outcome assessment within effectiveness studies, policy analysis and quality management. Dimensions of patients outcome that can be discerned are mortality, clinical parameters, health status and patient satisfaction. Some critical remarks have been placed on outcome assessment by clinicians. They have doubts on the relevance of outcome assessment, mainly because of the ambiguous relationship between process and outcome, especially regarding the dimension of health status. Furthermore, they are concerned about submitting individual patients to policy and clinical guidelines that are derived from outcome assessment of a group of patients. Arguably, what is good for society or for groups need not to be so beneficial to individual patients. To better involve clinicians in outcome assessment, knowledge is required on the extent to which an individual patient belongs to the population for which clinical and policy guidelines are used. Furthermore, more research is needed regarding the relationship between process and outcome, and regarding the connection between the outcome dimensions of clinical parameters, health status and satisfaction.