Outcome measures of psychiatric service delivery: How good are they?

The authors discuss the increasing importance of outcome measures as an indicator of quality of care in today\u27s behavioral healthcare market. They discuss who best should evaluate quality, what variables should be measured as the best indicators, and the most appropriate time frame for measuring outcomes. They conclude that outcome measures should include the perspective of the patient and significant others. Providers are in an especially good position to assess how well a course of treatment has worked, but there are a number of drawbacks in using providers to provide such evaluations, including cost, differing perspective from the patient, and possible biases. Outcome variables that might usefully be measured include changes in symptoms and functioning, adverse events, and patient satisfaction. The authors note that it is important to take case mix into account in interpreting the results of outcomes assessments. Since it is often not realistically possible to perform outcome measures at the end of treatment, the authors recommend initial baseline assessments, with follow-up measurements at reasonable intervals, perhaps 3-4 months. Factors to consider in evaluating the utility of outcome measures are reliability, validity, brevity, and cost. The authors describe a number of commonly used outcome measures and discuss what they measure and how they can most appropriately be used. The article concludes with suggestions for the types of outcome measurement that make sense in clinical practice. Copyright © Lippincott Williams & Wilkins Inc