Content area
Full text
Purpose: To provide a framework for classifying outcome indicators for a more comprehensive view of outcomes and quality.
Methods: Review of outcomes literature published since 1974 from medicine, nursing, and health services research to identify indicators. Outcome indicators were clustered inductively. Findings: Three groups of outcome indicators were identified: patient-focused, providerfocused, and organization-focused. Although investigators tend to focus on a select few outcome indicators, such as patient satisfaction, quality of life, and mortality, many indicators exist to measure outcomes.
Conclusions: Selecting and integrating a wide array of outcome indicators from the various categories will provide a more balanced view of health care delivery as compared with focusing on a few common indicators or only one category.
IMAGE: JOURNAL OF NURSING SCHOLARSHIP, 1999; .31:4, 381-388. @1999 SIGMA THETA TAU INTERNATIONAL.
[Key words: outcome indicators, outcome classification, outcome evaluation, outcome assessment]
Outcomes by definition are the results of care. Measurement of outcomes is therefore at the heart of debates about cost and quality, the effectiveness of care, and organizational performance. However, a precursor to outcomes measurement entails specifying which outcomes will be examined. Specifying outcomes necessitates clarity in the purpose of interventions and the goals to be attained, an understanding of care delivery processes, and access to suitable data for evaluating the results of care.
Classifying outcome indicators is an important step in outcome specification because it establishes a meaningful framework for viewing the various dimensions of outcomes. In our attempt to list the numerous possible indicators to assist people in recognizing and choosing more than the few select outcome indicators that are repeatedly used, a classification scheme was developed. Using this classification, we organized the array of outcome indicators into patient-focused, provider-focused, and health care organization-focused categories. This categorization of indicators represents a heuristic method for interpreting multiple aspects of outcomes.
Outcome Categories: Indicators and Issues
A pressing need exists to develop greater sophistication regarding outcome indicators so that the mix of indicators accurately reflects the full scope of problems being examined. Although many clinicians and researchers enthusiastically embrace the idea of measuring outcomes, they often remain confused about selecting and defending specific outcome indicators. A valid set of indicators must show the wide range of interrelationships and multiple systems in health care delivery...