Evaluation of multi-dimensional outcomes of chronic diseases: a clinical example from China.

The purpose of this study is to provide the evidence of individualized/personalized care by evaluating multi-dimensional outcomes of chronic diseases in the elderly. We used primary osteoporosis as an example, to evaluate the outcomes of three treatments (calcium combined vitamin D=Ca+vit.D; estrogen and disphosphonates) at the same time with biological dimension (bone-mineral density=BMD) and socio-psychological dimension (health-related quality of life=HR-QOL), using the medical outcomes study short-form 36-item health survey (SF-36) and cost dimension (drug cost). Using BMD as the outcome index, disphosphonate was the most effective treatment, in terms of HR-QOL, estrogen was the most effective while Ca+vit.D was the cheapest treatment, namely, different dimensional outcomes with different results. Outcome evaluation of chronic diseases in the elderly needs to combine psychological and socio-economic parameters together with the physiological measurement, to encourage a transition from "the disease-centered" to "the patient-centered" perspective as well as achieve sustainable and coordinated development of health and socio-economic resources.