What is the value of outcomes research?

It is ironic that we should have to answer the question: “what is the value of outcomes research?” when outcomes research is a key component of establishing the value of healthcare.

Despite the seemingly obvious answer, i.e. “we could not possibly establish the value of healthcare without outcomes research”, there is reason to pause. The meaning of the value of healthcare may not be entirely obvious, single works of outcomes research do not always provide all the information necessary to establish value, and the use of value assessment in real world policy-making is not always apparent.

What is the meaning of “value”? Critically, the value of healthcare depends on the perspective of the decision-maker who is assessing the value. For the government, the value may be in limiting expenditures for a programme such as Medicare or a National Health Service. Government decision-makers may also be directly concerned about the health of the population. For an employer, the value of healthcare may be in limiting workplace absenteeism. For an individual in the population, the value may be a combination of saving money, providing for a family, greater functionality, and enjoying life in general.

Outcomes research can document all these meanings of value, but a single study will rarely establish savings in medical care claims, changes in absenteeism, and changes in other aspects of quality of life. However, taken as a whole, multiple studies of outcomes provide information that can be critical for formulating policy. For decision makers to use the information in the process of making policy, those performing outcomes research must demonstrate not only the importance of their own work but the importance of the set of work into which their work fits. A coherent literature review that integrates a study into the extant literature is useful for achieving this objective.

Thus, outcomes research has value when each study, viewed in combination with other works, is useful in establishing the value of healthcare from multiple perspectives so that more informed policy can be made for the optimal allocation of healthcare resources.