ABSTRACT
This chapter explores the use of Patient-Related Outcome Measures (PROMs) as a tool that has evolved over time to measure the quality of care. The complexity of understanding improvements in healthcare is confounded by the way social conditions and health inequalities impact on healthcare. Social improvements such as better housing and smoking cessation alongside public health measures such as the provision of clean water have a positive impact on a society's health. Florence Nightingale was one of the first people to insist on measuring the outcome of care to evaluate the effect of treatment. She is also credited with creating the world's first performance measures of hospitals in 1859. However, despite this early foray into outcomes that were relevant to patients, healthcare outcomes have tended to be judged by markers such as blood pressure, blood test results or changes on radiological imaging.
