Abstract
Background : The use of outcome measures to monitor improved quality of care has been advocated for 20 years but has only achieved prominence with the increasing resource pressures and related changed in health service provision in the past 6 years. Objective : This paper describes the development of an approach to outcome measurement suitable for all patients receiving speech and language therapy. The measure, which is based on rating the dimensions of impairment, disability, handicap and well-being, is tested to assess whether it can usefully be used to compare the services of different providers. Method : Five trusts volunteered for the study. Service descriptions suggest that these services are typical for the purposes of providing speech and language therapy. Twenty-five therapists were trained to use the Therapy Outcome Measure (TOM); their reliability was assessed and they provided prospective data on clients with speech and language impairments related to dysphasia, stammering and dysphonia. Results : The study provides evidence indicating the differences in the types of patients being referred to different providers of speech and language therapy. Different services have different impacts on the number and type of domains and that services discharge patients at different points in their recovery. Discussion : Different outcomes by different providers may be associated with different referral policies, base populations, skills and work policies of therapists. Differences in outcomes associated with certain therapy services can initiate the task of analysing attributions and progress endeavours to provide equitable quality of care which is the philosophy underpinning the move towards benchmarking in health service delivery.