Physical and Emotional Function of Primary Care Patients: Scientific Requirements for the Measurement of Functional Health Status

The recent World Health Organization report, Development of Indicators for Monitoring Progress Towards Health for All by the Year 2000,1 focused attention on alternative indicators for measuring health problems. In the primary care setting, defining health in terms of diagnoses is problematic because often only symptoms and the functional status of the patient's problem are known, not the underlying pathophysiology.2,3 As more primary care health professionals attempt to evaluate scientifically the impact of their care on patients, they are faced with a new question—how should functional health status be measured in the primary care setting? In this issue of The Journal (p 3331), Nelson et al address the following questions: What is the level of physical and mental function of adult patients making office visits to primary care practices? How much agreement is there on function ratings between the clinician and the patient? What are the sources of