Posted by: notdeaddinosaur | May 17, 2012

Longitudinal Outcomes: a Primary Care Oxymoron

I’ve written about this before, but several recent events have brought the subject back to the fore: what exactly constitutes an “outcome” in primary care medicine?

Surgery has outcomes. Patient undergoes procedure; complications may ensue; convalescence proceeds; wound heals; life goes on.

Obstetrics has outcomes: conception, pregnancy, labor, delivery. Complicated or not; healthy baby, or sometimes tragically not. Six weeks later, patient is discharged from care.

Outcomes refer to events. Microbes invade; infection ensues; treatment is provided; patient recovers. Bones break and heal. Screaming metal collides, rending flesh; medics, helicopters, trauma codes, intensive care; those are events that yield meaningfully measurable outcomes.

Longitudinal care — ongoing care throughout the patient’s life — always has the same ultimate outcome: death.

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