Patient-centred evaluation and rehabilitative care.

The evaluation of health care outcomes is becoming increasingly important in today's health service. The wide range of measures used to evaluate these outcomes often makes clinical audit difficult and the comparison of research papers almost impossible. In this paper we will discuss some of the issues surrounding outcome measurement in rehabilitative care, examine one of the most commonly used outcome measures from this area (the Barthel Index) and consider Goal Attainment Scaling, a technique which offers both clinicians and researchers the opportunity to evaluate health care outcomes on the basis of patient-centred practice. We have identified certain methodological problems that need to be addressed if Goal Attainment Scaling is to become an acceptable measure in the area of physical rehabilitative care.