Measuring quality of life in a reformed health system.

"Quality of life" encompasses functional status, access to resources and opportunities, and sense of well-being. It offers a useful perspective on the value of health care, especially for chronically disabling conditions, including chronic mental illness. At least three major quality-of-life outcome assessment frameworks are available: general quality of life, health-related quality of life, and disease-specific quality of life. Choice of a framework must be driven by the intent of the services. For persons with chronic, disabling conditions, a general quality-of-life perspective is most appropriate, one that accounts not only for direct health outcomes but also for the potential social and economic effects of medical disability.