Finding health-related quality of life outcomes sensitive to health-care organization and delivery

OBJECTIVES. The author identifies and assesses health-related quality-of-life outcomes for evaluating health-care structure and process. METHODS. Development of a conceptual model and presentation of case studies are used to identify methods of outcomes research necessary to evaluate health-care organization and delivery RESULTS. Generic measures already exist for assessing functional status and well-being outcomes of health care. Condition-specific measures are necessary to address directly the concerns of patients and providers of care and to detect small differences in organizational arrangements. Improved health outcomes are more likely to be observed from large-scale prospective trials and studies using large data sets, but few studies report improved self-reported health status as linked to organizational structure. CONCLUSIONS. Theoretically driven research is necessary to link healthcare systems and outcomes. Outcome measures exist, but measurement development is needed for organizational arrangements, managed care structure and process, and stakeholder exchanges.