Outcome measures in speech therapy: impairment, disability, handicap and distress.

Recent changes in health service policies have led to renewed attention to the problem of measuring and relating outcome to health care provision. This has meant an increased focus on effectiveness itself, and a link with value for money. The effects of treatment have often defied measurement, and outputs, therefore, have replaced measures; the output of a service is important, but it should not be confused with outcome. This paper describes a simple method of measuring outcome reflecting the complex efforts of rehabilitation.