It is suggested that health care outcome measurement systems can be usefully conceptualized in terms of four components. This approach is discussed and illustrated with references to PsychSentinel, a system for measuring psychiatric outcomes. The four components are generic in the sense that they could be used to guide the development of a system for measuring outcomes for any medical specialty. The development of the components are sequential and interdependent. For each component developmental issues and guiding principles are presented. The four components are; a patient classification system, a measure of clinical change (the outcome), a risk-adjustment methodology, and one or more sets of reference norms.
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