The development of HRQOL instruments for children and adolescents has continued apace in recent years, particularly with regard to disease-specific questionnaires. Many of the instruments meet accepted standards for psychometric properties, although instrument developers should include children from the beginning of the development process and need to pay particular attention to testing sensitivity to change.

It is hoped that these instruments will be useful when included in the questionnaires of health surveys throughout Spain. The items selected facilitate evaluation of the degree to which primary health care succeeds as the first user contact with health services, maintains continuity of attention, coordinates and provides services, making them available when necessary. Furthermore, cultural competence will be evaluated.