The Outcomes Movement — Will It Get Us Where We Want to Go?

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Abstract
Arnold Relman, editor-in-chief of the Journal, has dubbed it "the third revolution in medical care."1 That description of what I call the outcomes movement may be hyperbole, but clearly we have entered an era of unprecedented growth in activity directed at the assessment of outcomes, the analysis of effectiveness, and quality assurance.There are many conspicuous manifestations of this type of activity. For example, the Joint Commission on Accreditation of Hospitals, moving away from its traditional reliance on structural measures, has formally embraced quality assessment based on severity-adjusted outcomes as the cornerstone of its future strategy for monitoring hospitals.2 , 3 Paul . . .

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