After a careful reading, Health Status Outcome (HSO) studies are focused on the ending result or outcome of medical care given, taking into account the health care process, and well being of patients and the population. Ultimately, these studies are looking at the health status of the patient and are related to diagnosis. For example, lab test results, complication rates, morbidity rates, functional status, well being, and satisfaction with care given are health status outcomes. Patient Reported Outcomes (PRO) are subjective reports generated from the patient either through diaries, self-completed questionnaires, or interviews regarding their treatment. PRO helps with research to evaluate patient’s perception, symptoms, satisfaction with treatment and adherence to regimens. Quality of Life measures the overall sense of optimal health and coping mechanisms incorporating the positive and negative challenges encountered. This can include physical, mental, sexual, and social self-perceived health status. Quality of Life can also reflect freedom from disease symptoms and the ability to perform daily activity with minimal compromise.

Quality of Life and health status have been used interchangeably by some researchers, but are regarded as separate measures by others. For example, according to Smith, Avis, & Assmann (1999) QOL has been examined as an outcome measure, and is an important endpoint in medical care. However, its definition still lacks clarity, especially in chronic disease. A Health Status Outcome (HSO) is an outcome or end result of medical care given, while in QOL, physical functioning and psychosocial variables are evaluated (Smith et al., 1999) These authors state, “QOL and health status are distinct constructs. When rating QOL, patients give greater emphasis to mental health than to physical functioning. This pattern is reversed for appraisals for health status, for which physical functioning is more important than mental health” (p. 447). These authors did not believe the two words should be used interchangeably.

HSO can be evaluated in chronic diseases, examining whether excellent or poor outcomes relate to life satisfaction. Subjects for recent study in this context are HIV infection, diabetes, and cancer (Smith et al., 1999). Differences in QOL include the interpretive subjective experience of one’s current life and psychological situation. HSO is based more explicitly on physical functioning. In another study by Lorig, Sobel, Stewart, Brown, Bandura, Ritter,… & Holman (1999) then you can use et al in future references studied patients with chronic disease who participated in a self-management program and had improved health status. I think you need another sentence here that ties the study more explicitly as a support for your point. Lastly “if a people feel that their health or well-being is poor, they may feel that their quality of life is also impaired, though this is not necessarily the case. The opposite- that just because they feel that their health is excellent and they are not depressed or anxious, their quality of life is excellent- may not be true either” (Bradley, 2001, p. 7). Health Status Outcomes and Quality of Life research will continue to help us as providers examine the total patient picture in the way we practice. It aids us in giving better health care to our patients and making the necessary changes in the care we give.

1. Describe practice and research endeavors where you would employ health status outcome and when you might use a patient reported outcome.

Currently asthma was an area that is used in my day to day practices and are currently growing in the research realm. Many patient within my rural area practice are asthmatic, some are low risk and some high risk. Example of research is used by Texas Children’s Medicaid monitors the amount of refills on Albuterol, this query is of the different doctors including our patients are run monthly. Once we are aware the high-risk the patient’ have to be educated and a self-questionnaire is of obtained and an asthma action plan is set up. Many patients on questions answers with low scores, which is perceived as out of control, but when asked they do not feel they have poor health status outcome and physically functional well. Myself, being diagnosed with Asthma at a late age a disease of remission and exacerbations is a constant battle. My health status is poor and unstable because the disease flares up most days of my life and it is physically draining. My PRO in relationship to Asthma Control Test Scores is measured by the self-completed questionnaires. I feel that my health status outcome affects both and it affects my functions of life and satisfaction with quality of life because of the constant flare-ups. Research is taken from the Asthma Control Test Scores from patients reported outcome scores including ages 4-11 and 12 and above, from any given score 19 or less is related to poor asthma control. I would differ in the diagnosis of hypertension; I have a much more positive outlook on life and report a better outcome as long as I take my recommended regimen. Research has also been researched in women that had breast cancer that complained of breast pain after surgery. Reported breast pain elicited impacted there health status and quality of life (Burchardt & Jones, 2005).

Currently, asthma is a disorder that is prevalent in my day-to-day practice and is currently the subject of a growing body of research. Many patients within my rural area practice are asthmatic, with both low and high risks for exacerbations and complications. An example of health status outcome research used by Texas Children’s Medicaid is monitoring the number of refills of Albuterol through a monthly system of queries of the different doctors including those treating our patients. Once we are aware the high-risk, the patients have to be educated, a self-questionnaire is of obtained and an asthma action plan is set up. Many patients provide answers on the questionnaires that provide low scores, which indicate asthma is poorly controlled, another HSO. Research is taken from the Asthma Control Test Scores from patients reported outcome scores including ages 4-11 and 12 and above, with any given score of 19 or less related to poor asthma control. However, when the patients are asked about their health, they often do not feel they have poor health status outcome and describe themselves as physically functioning well.

An example of an appropriately used patient reported outcome is personal. I was diagnosed with asthma at a late age; having a disease of remission and exacerbations is a constant battle. My PRO in relationship to Asthma Control Test Scores is measured by the self-completed questionnaires. I perceive my health status as poor and unstable because the disease flares up most days of my life and it is physically draining. I feel that my health status outcome affects both my functions of life and satisfaction with quality of life because of the constant flare-ups. Maybe a sentence her tying your personal experience to that of patients in the practice?

***I would differ in the diagnosis of hypertension; I have a much more positive outlook on life and report a better outcome as long as I take my recommended regimen. Research has also been researched in women that had breast cancer that complained of breast pain after surgery. Reported breast pain elicited impacted their health status and quality of life (Burchardt & Jones, 2005). *** I would cut out this paragraph and put in a concluding sentence that ties the two concepts together in a summary fashion

References
Bradley, C. (2001). Importance of differentiating health status from quality of life. The Lancet, 357(9249), 7-8.
Burckhardt, C. S., & Jones, K. D. (2005). Effects of chronic widespread pain on the health status and quality of life of women after breast cancer surgery. Health Quality Life Outcomes, 3(1), 30.
Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown Jr, B. W., Bandura, A., Ritter, P., ... & Holman , H. R. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Medical care, 37(1), 5-14.
Smith, K., Avis, N., & (1999). Distinguishing between quality of life and health status in quality of life research: A meta-analysis. Quality of Life Research, 8, 447-459.