title: Subjective well-being and the measurement of quality in healthcare.
abstract: Quality continues to be placed at the heart of discussions about healthcare. This raises important questions about precisely what quality care is, and how it should be measured. An overall measure of subjective well-being (SWB) that assesses and joins up different stages of the treatment process, and the different people affected, could potentially be used to capture the full impact of quality care throughout the entire treatment process. This article presents a temporal model through which SWB links all stages in the treatment and care process, thus allowing the overall quality of care to be determined and valued according to its direct effect on people's lives. Drawing on existing medical and behavioural studies, we populate this model with evidence that demonstrates how SWB is affected at different points along the patient pathway. SWB is shown to have an effect on outcomes at all stages of the treatment experience and improved health and quality outcomes are shown to consistently enhance SWB. Furthermore, SWB measures are shown to be a suitable method to value the impact of healthcare on the families and carers of patients and, in this way, can join up health outcomes to show wider effects of treatment on patients' lives. Measuring an individual's SWB throughout his or her treatment experience can enable a full appraisal of the quality of care that they receive. This will facilitate service improvements at the micro level and help value treatments for resource allocation purposes at the macro level.
authors.affiliation: Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, UK. Electronic address: henry.lee@imperial.ac.uk.
authors.forename: Henry
authors.initials: H
authors.lastname: Lee
authors.affiliation: Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, UK.
authors.forename: Ivo
authors.initials: I
authors.lastname: Vlaev
authors.affiliation: Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, UK.
authors.forename: Dominic
authors.initials: D
authors.lastname: King
authors.affiliation: Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, UK.
authors.forename: Erik
authors.initials: E
authors.lastname: Mayer
authors.affiliation: Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, UK.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.affiliation: Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Dolan
mesh_terms: D006801:Humans; D008962:Models, Theoretical; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology*
keywords: Patient experience; Quality; Quality of life; Subjective well-being