Subjective Indicators in the Health Sector and Their Usefulness in Policy Making

A considerable literature produced in the field of social sciences focused in the last 20 years on the importance of subjective indicators of wellbeing as an element of great significance in the analysis of public policies and quality of services, in addition to objective indicators. The health sector is characterized by a particular propensity and special consideration of the role of patients and other persons involved in the care process (family, doctors, nurses, etc.), and therefore of subjective elements. Since the end of the 1980s several studies considered the incongruences between health demand and health service supply and introduced in the debate the need to produce better evaluation methodologies, based on the interaction between objective an subjective data. The consequence was that subjective assessment by users and operators is now an integral part of any health service evaluation activity. The paper shows the evolution of scientific approaches to health services assessment, and the nature of subjective indicators mostly utilized in recent Italian experiences. Special attention is dedicated to an interesting attempt to enlarge the evaluation approach, aim of which is to contribute to the assessment of the social impact of administrative actions and public services stimulating the contribution of social parties and independent experts and involving public authorities and policy-makers.