HEALTH OUTCOMES BY SELF-REPORT - VALIDITY OF THE SF-36 AMONG AUSTRALIAN HOSPITAL PATIENTS

This paper examines the performance of the SF-36 as a self-reported ou tcome measure in a diverse sample of Australian hospital in-patients. The data derive from the Care Continuum and Health Outcomes Project wi th a total of 2088 randomly selected patients, yielding a response rat e of 80%. Distributions, completion rates and, in particular, correlat es of measures were used to investigate the validity of the SF-36 acco rding to clinical and psychometric criteria. Physical functioning, bod ily pain, role limitations- physical, general health and vitality scal es better represented physical than mental hearth, with the relative s trength decreasing in that order; while mental health, role limitation s-emotional and social functioning scales better represented mental he alth, with the relative strength decreasing in order. A cultural dimen sion was a strong independent correlate of all scales. While the SF-36 performed satisfactorily, there were weaknesses: the social functioni ng scale was too narrow to cover social health, both role limitations scales had crude response categories and particular subgroups, the fra il elderly and those with complex health conditions, required measures with finer gradings for scales such as physical functioning and bodil y pain. Further testing is needed to develop self-reports for use in h ospital outcomes measurement which is already proposed in Australia.