title: Overall self-rated health: a new quality indicator for primary care.
abstract: OBJECTIVE
  Patient 'empowerment' gives patients choices about their own care and about the outcomes they would most prefer. Many patients can be presumed to regard overall self-rated health as an important outcome. Therefore, overall self-rated health can be considered a relevant and important outcome measure for a patient-centred medical clinic. The purpose of this study was to use this new outcome measure as a dependent variable and to test the hypothesis that patients who are confident about their ability to manage their health will have better health, in comparison to more dependent patients.
  
  
  METHODS
  We conducted a randomized cross-sectional postal survey of 500 veteran patients from the Panhandle of Texas and the surrounding areas; and 302 participated in the study. Multiple logistic regression analysis was used to test the hypothesis that health confidence is positively related to self-rated health, controlling for obesity, cigarette smoking and participation in recreational activities.
  
  
  RESULTS
  Veterans who strongly disagreed with the statement that they usually could overcome illnesses on their own were less likely to report good, very good or excellent self-rated health (adjusted odds ratio=0.25).
  
  
  CONCLUSIONS
  Overall self-rated health as measured by a single question proved to be significantly related to behavioural risk factors in this sample of primary care patients, attesting to its validity as an outcome indicator. Furthermore, health confidence was associated with better health. Most primary providers believe that they can, through good communication and providing self-care tools, increase healthy behaviours in their patients. If we are indeed able to increase health confidence in our patients, this study would suggest that self-rated health would improve.
authors.affiliation: Department of Family Medicine, Mayo Clinic, Rochester, MN 55905, USA. rohrer.james@mayo.edu
authors.forename: James E
authors.initials: JE
authors.lastname: Rohrer
authors.forename: Rodney
authors.initials: R
authors.lastname: Young
authors.forename: Virginia
authors.initials: V
authors.lastname: Sicola
authors.forename: Margaret
authors.initials: M
authors.lastname: Houston
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000592:standards*; D011788:Quality of Life; D012649:Self Concept; D016353:Self-Examination