title: Health-related quality-of-life data should be regarded as a vital sign.
abstract: OBJECTIVE
  The health care system systematically collects data on risk factors, processes of care, and the amount and type of services provided; in short, it mainly measures inputs. The system only sporadically collects data on the health status and health-related quality of life (HRQL) of those served. What does the system actually produce? It produces quality-adjusted survival; yet, there is little systematic effort to collect such outcome-output data.
  
  
  METHODS
  Systematic routine use of HRQL instruments to assess the health of all patients is one step toward filling this void.
  
  
  RESULTS
  Assessing the HRQL on all patients provides the information needed to create a report card on the system. Furthermore, the routine use in the context of chronic care management has the potential to improve patient-clinician communication, provider and patient satisfaction, shared decision making, and health outcomes.
  
  
  CONCLUSIONS
  Over five decades of methodological development have provided a rich array of HRQL instruments. A plethora of technologies facilitate the collection, transmission, and storing of information. What is needed is training to assist patients and providers in the meaning and use of such information and the will to use it to improve performance, accountability, and patient care. Administrative support is also necessary.
authors.affiliation: Department of Economics, University of Alberta, 1209 SW Sixth Avenue, Unit 801, Portland, OR 97204-1030, USA. dafeeny@comcast.net
authors.forename: David
authors.initials: D
authors.lastname: Feeny
mesh_terms: D006304:Health Status; D006801:Humans; D017060:Patient Satisfaction; D011785:Quality Assurance, Health Care; D011788:Quality of Life; D055986:Vital Signs