Measuring outcomes in the postacute continuum.

Measuring outcomes across the postacute continuum presents both practical and technical challenges. It requires capturing a variety of information across multiple therapeutic disciplines and care settings. While this information is collapsed into a single patient record, the ability to assess the contribution of each component to the overall outcome must be retained. Current health care data systems tend to fragment the information into discrete stays. Extant outcome instruments are perceived as being insensitive to change in noninpatient settings. The technology exists to correct shortcomings in both the information and the outcome assessment systems. The latter difficulties are the more complex, but by understanding the relationship between the measuring instrument and what it measures, and by properly matching the instrument to the level of the patient and the goals of the treatment program, many obstacles to effective outcomes management in the postacute continuum can be overcome. In a time of rapid change and experimentation in health care, however, outcomes managers must recognize that negative outcome data can result from ineffective programs as well as inappropriate instruments.