Outcome data and quality: the critical role of policy.

Health outcomes data are a major focus of the Australian health policy debate and the national research agenda. There is general agreement that health outcomes data should be collected. Outcomes data have been shown to be a powerful stimulant to service quality at the clinical level. It is argued here that policy which places health outcomes data at the centre of resource allocation and competitive cost control strategies is likely to undermine its capacity to stimulate quality at the clinical level. Policy is needed to support the role of health outcomes data so that it is relevant to clinicians and is seen as being fundamental to quality improvement processes at the organisational level. Governments and other funding bodies require that services be accountable for the quality of their services. By using health outcomes data this quality guarantee can be based on evidence that the data are analysed routinely and, where appropriate, clinical services are modified and improved. Without this clear role for health outcomes data, they may become yet another 'top-down' accountability tool that has little relevance to clinicians and therefore loses its value as a stimulant to quality improvement.