Problems and new directions in the evaluation of primary care

The nature of many contacts between patients and first-contact doctors (e.g. general practitioners) is such that the traditional morbidity and mortality indices of outcome are inadequate for evaluating the care provided. Preliminary results of a study developing a more appropriate index of the outcome of primary care, expressed in terms of the patient's functional abilities, are discussed. Beyond its use in evaluating the social and psychological components of care, the method may be applicable in population health surveys and in estimating the need for care.