This paper discusses the use of subjective health assessment in medical practice and social policy-making. The importance of recognising patients' perceptions of their health when attempting to improve patient-practitioner relationships and formulate effective health care policies is stressed. The paper describes some of the tensions that exist between objective and subjective assessments of health. It is argued that there is a need for a unifying theory to underpin the use of subjective health perceptions. Suggestions are made for the effective employment of these indicators.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Barbour, A. (1995).Caring for Patients, Stanford University Press, Stanford, California.
Inglehart, J. (1995). Health policy report: Medicaid and managed care.New England Journal of Medicine 332, 1727–1731.
Gelijns, A. C. and Their, S. O. (1990). Medical technology development: an introduction to the innovation-evaluation nexus. In,Modern Methods of Clinical Investigation, ed. by A. C. Gelijns, National Academy Press, Washington DC.
Muller, C. F. (1990).Health and Gender, Russell Sage Foundation, New York.
Wilson, J. D., Braunwold, E., Isselbacher, K. J., Peterdorf, R. G., Martin, J. B., Fauci, A. S. and Root, R. K. (1991).Harrison's Principles of Internal Medicine, 12th edn, McGraw-Hill, New York.
Albert, D., Munson, R. and Resnick, M. D. (1988).Reasoning in Medicine: An Introduction to Clinical Inference, The Johns Hopkins University Press, Baltimore.
Waitzkin, H. (1991).The Politics of Medical Encounters, Yale University Press, New York.
Stanton, A.L. (1987). Determinants of adherence to medical regimens by hypertensive patients.Journal of Behavioural Medicine 10, 377–394.
Villar, J., Farnor, U. and Barros, F. (1992). A randomized trial of psychosocial support during high-risk pregnancies.New England Journal of Medicine 327, 1266–1271.
Herzlich, C. and Pierret, J. (1987).Illness and Self in Society, The Johns Hopkins University Press, Baltimore.
Pope, A. and Tarlov, A. (1991).Disability in America: toward a national agenda for prevention, National Academy Press, Washington DC.
Patrick, D. L. and Erickson, P. E. (1993).Health Status and Health Policy: Allocating Resources to Health Care, Oxford University Press, Oxford.
Jette, A. M. (1980). Health status indicators: their utility in chronic disease evaluation research.Journal of Chronic Diseases 33, 567–569.
Bergner, M. (1985). Measurement of health status.Medical Care 23, 696–704.
Ware, J. E. (1986). The assessment of health status. In,Applications of Social Science to Clinical Medicine and Health Policy, ed., by L. H. Aiken and D. Mechanic, Rutgers University Press, New Brunswick, NJ.
Stewart, A. L. (1993). The medical outcomes study framework of health indicators. In,Measuring Functioning and Well-being, ed. by A. L. Stewart and J. E. Ware, Duke University Press, Durham.
Applegate, W., Blass, J. and Williams, T. (1990). Instruments for the functional assessment of older patients.New England Journal of Medicine 322, 1207–1214.
Bowling, A. (1991).Measuring Health: A Review of Quality of Life Measurement Scales, Open University Press, Bristol.
Bullinger, M. (1995). German translation and psychometric testing of the SF-36 health survey: preliminary results form the IQOLA project.Social Science and Medicine 41, 1359–1366.
Fitzpatrick, R., Hinton, J., Newman, S., Scambler, G. and Thompson, J. (eds.) (1984).The Social Experience of Illness, Tavistock Publications, London.
Fadan, R. and Leplege, A. (1992). Assessing quality of life: moral implications for clinical practice.Medical Care 30, 166–175.
Heyink, J. (1990) Adding years to your life or adding life to your years.International Journal of Health Sciences 1, 45–50.
Robinson, I. (1990). Personal narratives, social careers and medical courses: analysing life trajectories in autobiographies of people with multiple sclerosis.Social Science and Medicine 30, 1173–1186.
Katz, S. and Akpom, C. (1976). Index of ADL.Medical Care 14, 116–118.
Albrecht, G. L. and Higgins, P. C. (1977). Rehabilitation success: the interrelationships of multiple criteria.Journal of Health and Social Behaviour 18, 36–45.
Levine, S. (1987). The changing terrains in medical sociology: emergent concern with quality of life.Journal of Health and Social Behaviour 28, 1–6.
Johnson, R. J. and Wolinsky, F. (1993). The structure of health status among older adults: disease, disability, functional limitation, and perceived health.Journal of Health and Social Behaviour 34, 105–121.
Cook, T. D. and Campbell, D. T. (1979).Quasiexperimentation: Design and Analysis Issues for Field Settings, Rand-McNally, Chicago.
Rothman, M. L., Hedrick, S. C., Bulcrot, K. A., Hickman, D. H. and Rubenstein, L. Z. (1991). The validity of proxy-generated scores as measures of health status.Medical Care 29, 115–124.
Magaziner, J., Simonscik, E. M., Kashner, T. M. and Hebel, J.R. (1988). Patient-proxy response comparability on measures of patient health and functional status.Journal of Clinical Epidemiology 41, 1065–1074.
Epstein, A. M., Hall, J. A., Son, L. H. and Conant, L. (1989). Using proxies to evaluate quality of life: can they provide information about patients' health status and satisfaction with medical care?Medical Care 27, S91-S98.
Cox, D., Fitzpatrick, R., Fletcher, A.et al. (1992). Quality of life assessment: can we keep it simple?Journal of the Royal Statistical Society 155, 353–393.
Spilker, B. (1990).Quality of Life Assessment in Clinical Trials, Raven Press, New York.
Quirk, F. and Jones, P. (1990). Perception of distress due to symptoms and effects of asthma on daily living and an investigation of possible influential factors.Clinical Science 79, 17–21.
Janson-Bjerklie, S.et al. (1992). Clinical markers of asthma severity and risk: importance of subjective as well as objective factors.Heart and Lung 21, 265–272.
Bergner, M., Barry, M. J., Bowman, M. A., Guess, H.A. and Nutting, P.A. (1992). Where do we go from here: opportunities for applying health status assessment measures in clinical settings.Medical Care 30, 219–230.
Rogerson, R. J. (1995). Environmental and healthrelated quality of life: conceptual and methodological similarities.Social Science and Medicine 10, 1373–1383.
Mark, D. B.et al. (1994). Use of medical resources and quality of life after myocardial infarction in Canada and the United States.New England Journal of Medicine 331, 1130–1135.
Ebrahim, S. (1995). Clinical and public health perspectives and applications of health-related quality of life measurement.Social Science and Medicine 41, 1383–1394.
Zautra, A. J.et al. (1995). Arthritis and perceptions of quality of life: an examination of positive and negative affect in rheumatoid arthritis patients.Health Psychology 14, 399–408.
Wilson, I. and Cleary, P. (1995). Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes.Journal of American Medical Association 273, 59–65.
Delbance, T. (1995). Doctors and patients: breaking down the walls.the Quality Letter 7, 3–18.
Ginsburg, P. and Hammons, G. (1988). Competition and the quality of care: the importance of information.Inquiry 25, 108–115.
Ross, J. and Albrecht, G. (1995). Escalation in health care delivery: contextual effects in physician diagnosis and treatment decisions.Research in the Sociology of Health Care 12, 241–260.
Schlesinger, M., Cleary, P. D. and Blumenthal, D. (1989). The ownership of health facilities and clinical decision-making.Medical Care 27, 244–257.
Bach, J. and Tilton, M. (1994). Life satisfaction and well-being measures in ventilator assisted individuals with traumatic tetraplegia.Archives of Physical Medicine and Rehabilitation 75, 626–632.
Ware, J. (1995). The status of health assessment.Annual Review of Public Health 38, 231–257.
Nacon, A. and Booth, T. (1991). The social impact of asthma.Family Practice 8, 37–44.
Fries, J. F., Spitz, P. W., Kraines, R. G. and Holman, H. R. (1980). Measurement of patient outcomes with arthritis.Arthritis and Rheumatism 5, 137–145.
Guyatt, G., Berman, L., Townsend, M.et al. (1987). A measure of quality of life for clinical trials in chronic lung disease.Thorax 42, 773–778.
Framoze, A. (1995). A look at rehab outcomes.Rehabilation Management 5, 60–65.
Deyo, R. and Carter, T. (1992). Strategies for improving and expanding the application of health status measures in clinical settings.Medical Care 30, 176–186.
McSweeny, T and Creer, T. (1995). Health related quality of life assessment in medical care.Disease-A-Month, 1–71.
Glik, D. and kronnenfeld, J. J. (1989). Well roles: sociological perspectives.Research in the Sociology of Health Care 7, 289–309.
About this article
Cite this article
Albrecht, G. Using subjective health assessments in practice and policy-making. Health Care Anal 4, 284–292 (1996). https://doi.org/10.1007/BF02249315