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Capturing the full measure of patient outcome improvement using a self‐assessed health adjustment
Author(s) -
Long Michael J.,
McQueen David A.,
LescoeLong Mary,
Schurman John R.
Publication year - 2005
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2005.00563.x
Subject(s) - medicine , intervention (counseling) , outcome (game theory) , physical therapy , health care , emergency medicine , nursing , mathematics , mathematical economics , economics , economic growth
Rationale Self‐assessed health (SAH) status is a very simple four‐, or five‐category self‐reported measure of health status that has been shown to be a powerful predictor of mortality, service use and total cost of medical care treatment. It is therefore reasonable to suggest that pre‐intervention SAH may influence the extent to which patient outcomes improve following surgery. Methods Using the four‐category measure of SAH of Excellent; Good; Fair; Poor, we developed an adjustment factor based on the mean improvement of the SAH category relative to the mean improvement of the overall sample. Results The results clearly indicate that the higher patients rated their pre‐operative health, the greater their pre–post‐operative improvement. Adjusting the outcome improvement by this SAH factor provides for the adjustment of the overall sample results by extent to which each category of SAH contributes to the overall mean. Conclusion The results indicate that by adjusting patient outcome improvement measures by a factor based on pre‐intervention SAH, overall sample patient outcome improvement increased 5.8%. The results also indicate that failure to adjust for pre‐intervention SAH will result in an understatement of patient outcome improvement following surgery.