Social Interventions and Outcomes in Medical Effectiveness Research

A new field, known as "outcomes research" or "medical effectiveness research," has been embraced by policy makers and managers as the basis for controlling costs, improving quality, and establishing accountability. Research in this field has already migrated to health-care problems that are primarily social, not medical, in nature. This article describes the principles and approaches characteristic of medical effectiveness research and analyzes the treatment of social factors in the current generation of studies. The article proposes a framework, in this case applied to home health care, that more rigorously incorporates social factors into outcomes research.