OUTCOMES RESEARCH - A PRIMER FOR PLASTIC SURGEONS

The growing emphasis on cost-effectiveness in the United States health care industry has highlighted the need for comprehensive outcomes res earch in a variety of medical specialties. Currently, there is a relat ive paucity of reliable data characterizing the long-term results of m any medical and surgical treatments. This shortage of outcomes researc h is particularly acute within plastic surgery where the benefits of t reatment are often intangible and notoriously difficult to measure. In evaluating the effectiveness of medical treatment, conventional clini cal research has focused primarily on morbidity and mortality as the o utcomes of interest. In contrast, current outcome studies assess the r esults of interventions from the patient's perspective, measuring the impact of medical care on physical functioning, well-being, and qualit y of life. The resulting data can assist consumers, providers, and pay ers in making more appropriate health care decisions. As the outcomes movement has matured, it has evolved into two major areas of study: ef fectiveness research that evaluates the relationships between specific medical interventions and outcomes of care, and quality assessment th at seeks to provide the best outcomes at the most reasonable costs. Th is review details the origins and trends of current outcomes research, examining the implications of this movement for plastic surgery. The growing impact of outcomes data on treatment guideline formulation in both the public and private sectors is also described. Finally, a brie f review of outcomes study design, including definition of variables a nd selection of instruments, is presented.