Introduction

One of the most important developments in the assessment of healthcare performance in recent years has been the demonstration that patients' and users' experiences of health and illness can be reliably and accurately captured by very simple means. It is now possible to capture aspects of health that are of most concern to individuals and populations – usually with self-completed and fairly short questionnaires. Typically these ask respondents to report, describe or assess aspects of their current health (e.g. symptoms); and the physical, psychological and social impact of health problems. The technical and scientific developments that have resulted in this capacity to capture patients' experiences have occurred over the last thirty years and these methods can now be considered mature, established and well-understood.

This chapter reviews the range of measures available and describes key considerations for selecting these for particular applications. It also considers the scope for widespread use of these measures to monitor health-care performance and the barriers that may limit such uses. Instruments in this field have been variously termed measures of quality of life, health status, health-related quality of life, subjective health status and functional status. The most important use of these questionnaires is for assessing outcomes of health care and increasingly they are referred to as patient-reported outcome measures (PROMs), the term used here.