OPINION: Rethinking health outcomes in the era of multiple concurrent chronic conditions

Modern health care is very much concerned with outcomes. The language of outcomes is common in policy development, clinical work, and research. For example, Health Quality Ontario states that the overall quality aims are: Better outcomes, better experience, better value for money.

In the context of clinical care, outcomes are broadly considered to be the results brought about by care delivered to patients by healthcare providers. At the population level, outcomes are understood in terms of metrics such as rates of disease, mortality rates, and other measures of interest. In theory, at least, outcomes are closely related to the desired health-related goals of individuals and populations.

The increased focus on outcomes is understandable given the vast resources our society now devotes to health care. The quest for “better” outcomes is welcome and to be encouraged. However, understanding what exactly constitutes a “better” outcome presents a significant challenge. Understanding outcomes is particularly important as health systems also claim to be person-centred, meaning they are structured to address the particular needs of any given patient seeking care in the system. It is unclear what types of outcomes modern health care should be pursuing. This is particularly the case in the context of an aging population with increasing chronic disease burdens.

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