The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
We focus on a number of topic areas identified by state health policy leaders as important to population health.
The Center for Evidence-based Policy at Oregon Health & Science University is a national leader in evidence-based decision making and policy design.
Keep up with news and updates from the Milbank Memorial Fund. Get the latest from thought leaders, including Christopher F. Koller, president of the Fund.
We publish The Milbank Quarterly, as well as reports and issues briefs on topics important to population health.
March 1974 (Volume 52)
March 1974 | Barbara Starfield
The need to demonstrate that health care has an influence on health status is increasingly pressing. Such demonstrations require tools of measurement which are unfortunately not available. Development of instruments has been hampered by a lack of consensus on appropriate frames of reference, and there appears to be little agreement on what should be measured and what relative importance should be ascribed to different dimensions of health status. An approach that does not require the assignment of numerical values or weights to various aspects of health status and is applicable to all age groups within the population and to the whole spectrum of health problems rather than to specific medical diagnoses would seem desirable. A scheme that is based upon the development of a “profile” rather than a single “index” for describing health status is proposed in this paper. The model is a conceptual framework whose usefulness will depend upon efforts of a large number of researchers from many disciplines to develop instruments which can be incorporated in it. Although the problems in development of the scheme are complex, I hope that it will focus attention on the relevant dimensions and facilitate improved coordination of efforts to produce ways to demonstrate what health care contributes to health.
Author(s): Barbara Starfield
Download the Article
Read on JSTOR
Volume 52, Issue 1 (pages 39–50)
Published in 1974
Innovation of Health Services: A Comparative Study of Hospitals and Health Departments
Abortion Programs in New York City: Services, Policies, and Potential Health Hazards