Routine clinical outcomes measurement in old age psychiatry

Abstract

It is puzzling that major public health systems in the developed world do not engage in the routine clinical outcomes measurement (RCOM) of their interventions. For example, the budget of the U.K. National Health Service (NHS) for 2008/9 was £81 billion, with 15 million inpatient episodes, yet a Martian's question “How much better are these patients for all this expense?” cannot be answered for any but a tiny proportion of them, and then only by local enthusiasts. It is true that death rates of patients are now routinely and publicly reported, but as Florence Nightingale – whose reputation was made and then almost destroyed by mortality statistics (Iezzoni,1996) – herself remarked: