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Managing by numbers: using outcome measures in the NHS.

S McCartney1, R B Brown

  • 1Department of Accounting, Finance and Management, University of Essex, Colchester, UK.

International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services
|June 3, 1999
PubMed
Summary

Measuring health service outcomes is crucial for "value for money" initiatives. However, consistently effective outcome measures remain elusive, and their use as management tools can distort original meanings.

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Research summaries·2014

Area of Science:

  • Health Services Research
  • Healthcare Management
  • Outcome Measurement

Background:

  • The National Health Service (NHS) increasingly emphasizes "value for money" approaches.
  • There is a growing need to measure health outcomes following patient encounters with health services.
  • Provider units are mandated to assess the health effects of interventions on individuals.

Purpose of the Study:

  • To explore the literature on outcome measures within health services.
  • To critically examine the challenges and limitations of using outcome measures in healthcare.

Main Methods:

  • Literature review of existing research on health outcome measures.
  • Analysis of the conceptual and practical difficulties in defining and applying outcome measures.

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  • Discussion of the implications of using outcome measures as management tools.

    • Main Results:

    • Definitions of health outcomes are problematic for both professionals and managers.
    • Universally applicable and effective outcome measures are difficult to achieve.
    • The effectiveness of outcome measures is context-dependent.
    • Using outcome measures for management can lead to a subversion of their intended meaning.

    Conclusions:

    • Outcome measures that meet all requirements are likely to remain elusive.
    • The utility and interpretation of outcome measures vary significantly with their context of use.
    • Managing healthcare solely based on outcome measure data is not a sustainable or realistic strategy.