ABSTRACT
The first problem to be confronted when discussing outcome measurement in the field of health is whether we are to concentrate on health-as-affected-by-health-care, or whether our interests are the broader ones of evaluating all public sector activities (and all private sector activities too?) which impinge upon health. The latter is such a broad canvas that I have decided to set it aside in the present context, despite the obvious dangers of so doing. Prime amongst these dangers is that of encouraging people to believe that health care is the most important determinant of health, when probably that role goes to income, with education and smoking status following close behind! So, although I am going to concentrate on the measurement of outcome in a (public) health care system, this should not be taken as implying that I consider the health care system as the most important source of health in society.
