A rehabilitation of health outcome in quality assessment.

The purpose of this paper is to outline a conceptual framework for analysing the quality of health care. This framework brings together the dominant notions within the medical literature and an approach taken in economics, specifically, the 'characteristics' or 'wants satisfaction' theory of consumer demand. It is suggested that this 'new' theory of consumer demand can provide an operational definition of the quality of health services. We give an account of how the relationship between patient satisfaction, cost and outcome may be synthesized and we discuss how this synthesis relates to assumptions, in the medical literature, of a relationship between structure, process and outcome factors of the quality of care.