882 © 2007 The Authors. Journal compilation © 2007 Blackwell Publishing Ltd, Journal of Evaluation in Clinical Practice 13 (2007) 882–888 Journal of Evaluation in Clinical Practice ISSN 1356-1294 Blackwell Publishing LtdOxford, UKJEPJournal of Evaluation in Clinical Practice1356 1294© 2006 The Authors; Journal compilation © 2006 Blackwell Publishing Ltd2006136882888Original Article Overall self rated healthJ.E. Rohrer et al. Overall self-rated health as an outcome indicator in primary care James E. Rohrer PhD, 1 Ahmed Arif MD PhD, 2 Anne Denison RN MS, 3 Rodney Young MD 4 and Steve Adamson MD 5 1 Professor, Department of Family Medicine, Mayo Clinic, Rochester, MN, USA 2 Assistant Professor, Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA 3 Epidemiologist, Veterans Affairs Medical Center, Amarillo, TX, USA 4 Chair, Department of Family Medicine, Texas Tech University Health Science Center, Amarillo, TX, USA 5 Chair, Department of Family Medicine, MAYO Clinic, Rochester, MN, USA Abstract Rationale, aims and objectives The ultimate goal of health care systems is to improve overall health from the patient’s point of view. However, overall self-rated health is routinely monitored as a performance indicator. The purpose of this study was to in gate the feasibility of using a measure normally employed in community health sur a quality indicator in primary care clinics. Methods In order to do so, we conducted a cross-sectional survey of community med patients treated in five clinics in Amarillo, Texas to test the theory that, in primary patients, a single-item measure of self-rated health is significantly related to the us factors found in community health surveys (environmental factors, demographic ch istics and health behaviours). Results Multiple logistic regression analysis revealed that age, race, frequent distress, current smoking and health confidence were independently related to the reporting good health. Conclusion Our results support using a single-item measure of self-rated health in pr mary care. Our data also suggest that encouragement of health confidence would a be in the best interests of patients. Introduction Patient-centredness and empowerment have become important goals for primary care providers. Overall self-rated health is one of the most important patient-oriented outcomes, and therefore is an appropriate focus for managerial research in primary care. When an average person rates his or her health as excellent, very good or good, then the health care organization and the health profession- als serving it have done a good job in promoting health. Further- more, the validity of single-item subjective measures of overall health has been firmly established in population studies [1–8]. However, the use of single-item measures of overall health in primary care settings has lagged, presumably because of the con- cerns that such measures would lack sensitivity or because of the assumption that health status can only be used as an outcome indicator in prospective studies. Interestingly, the use of patient satisfaction as an outcome measure in cross-sectional studies is not questioned. Since primary care providers are now beginning to see their role as one of ‘managing’ the health of their continuing patients, the time has come to use overall health as an outcome measure. The body of knowledge regarding predictors’ good self-rated health for persons in the general population has increased consid- erably in recent years. Starting with the basic behavioural deter nants of poor health (e.g. cigarette smoking, poor nutrition, lack exercise, failure to receive preventive medicine), investigato have broadened the field of study so that it now ranges fr broad-social concerns (e.g. income inequality) to idiosyncrat psychological characteristics of individuals (e.g. depression). Health-promoting aspects of the environment also have bee examined, including the ‘walkability’ of neighbourhoods and the level of crime, both of which are related to subjective hea ratings [9,10]. The primary purpose of this analysis was to test the theory tha overall self-rated health is related to the risk factors normally fo to be important in community health surveys. Demonstrating thi finding would support the predictive validity of a single-item me sure of overall self-rated health when used in primary care samp We used as our sampling frame a community medicine research network composed of a diverse variety of clinic types. Methods We used a cross-sectional survey to test the theory that patients who have better self-rated health also report healthier lifestyles positive environmental characteristics and better mental hea Keywords community medicine, health confidence, quality, self-rated health Correspondence James Rohrer Mayo Clinic 200 First Street SW Rochester, MN 55905 USA E-mail: rohrer.james@mayo.edu Accepted for publication: 8 May 2006 doi:10.1111/j.1365-2753.2006.00766.x