Autoperception and satisfaction with health: two medical care markers in elderly hospitalized patients. Quality of life as an outcome estimate of clinical practice.

This paper reports a prospective study, carried out in elderly patients hospitalized for acute illness, designed to evaluate the effectiveness of medical treatment from the point of view of quality of life (QoL). Patient's autoperception and satisfaction with health, the most relevant subjective estimates of QoL, were assessed on admission to hospital and at check-up after discharge. A comprehensive functional evaluation of the patients was made. The results indicated an improvement in health autoperception coherent with the professional view. However, health satisfaction was not modified in any way after medical treatment. This dissonance could be explained because the predictors of satisfaction, age, sex, functional status and comorbidity, are the factors least modified by treatment. Satisfaction with ones own health could be a crucial marker of QoL especially for chronic diseases, but not appropriate for monitoring treatment effectiveness of acute illness. Health autoperception seems to be more desirable as an outcome estimate for this purpose.