Outcomes Research

The term outcomes research is defined as determining the value of health care by evaluating clinical outcomes.

Health outcomes research combines features of clinical research, continuing medical education, and quality assurance. Patient outcomes can be characterized in terms of a number of dimensions, including clinical factors, death, disease, functional status, well-being, satisfaction, and cost.

Typically, outcomes research is distinguished from traditional clinical trials-based research by two factors: (a) Outcomes research uses uncontrolled, observational data, which provide a “real-world” view of clinical practices and outcomes in representative patients; and (b) outcomes research frequently includes patients' self-reports that reflect quality of life, functional status, and satisfaction with care.

The outcomes movement was founded on the principle that patient care will improve if physicians are provided with timely and credible information linking local clinical practices and patient outcomes. Most physicians have little or no opportunity for ongoing, objective feedback about the relationship between their patterns of clinical practice and patient outcomes. Moreover, physicians may change practices in response to anecdotal information, such as a particularly good (or bad) outcome in an individual patient, which may not be representative of their overall clinical experience. Physicians need, but seldom have access to, benchmark data that allow comparison of individual practice patterns and outcomes with the experiences of their peers in caring for comparable patients.

From a pharmacoeconomic perspective, it is increasingly important for physicians and health care systems to demonstrate that they provide care that leads to superior outcomes, particularly in comparison with care rendered by other practitioners. Payers are shifting the increasing burden of health care costs to hospitals and providers. Hospital administrators are under intense pressure to reduce costs. Without objective data to substantiate the relationship between specific clinical care practices and clinical outcomes, payers and hospital administrators may limit care in ways that are harmful to patients. In contrast, objective data may demonstrate that certain types of care have no or very limited impact on health outcomes and thus can reasonably be discontinued.

Data from outcomes research empower clinicians to monitor and improve their practices and outcomes. These data can guide the development of educational programs to improve the care of patients and can provide a mechanism for physicians to evaluate the impact of their diagnostic and therapeutic decisions in a manner that is timely and objective.