Epidemiology and the delivery of health care services : methods and applications / edited by Denise M. Oleske.

Format:

Book

Contributor:

Oleske, Denise M.

Language:

English

Subjects (All):

Health planning--Methodology.

Health planning.

Epidemiology.

Health services administration.

Health Planning--methods.

Delivery of Health Care--organization & administration.

Epidemiologic Methods.

Medical Subjects:

Epidemiology.

Health Planning--methods.

Delivery of Health Care--organization & administration.

Epidemiologic Methods.

Physical Description:

xix, 401 pages : illustrations ; 26 cm

Edition:

Second edition.

Place of Publication:

New York : Kluwer Academic/Plenum, [2001]

Contents:

Chapter 1 An Epidemiological Framework for the Delivery of Health Care Services / Denise M. Oleske 3

An Epidemiological Model for the Delivery of Health Care Services 3

The Population 4

Population Trends 6

Need for Health Care 6

Utilization of Health Care Services 10

Factors Affecting Health Care Utilization 12

Accessibility of Health Care 13

Availability of Health Care Resources 13

Health of Populations Served 14

Applying Epidemiology in Health Care Management Practice 15

Monitoring Service Population Size 15

Distribution of Health Needs in a Population 16

Understanding the Genesis and Consequences of Health Problems 18

Understanding the Relationship between Health System Characteristics and the Health Status of Populations Served 18

Monitoring Health Care Systems, Organizations, and Program Performance 19

Modifying the Structure and Processes to Respond to Environmental Change 20

Formulation and Evaluation of Public Policy Affecting the Delivery of Health Care Services 20

Chapter 2 Measurement Issues in the Use of Epidemiological Data / Denise M. Oleske 29

Methods of Measurement 29

Validity and Reliability of a Measure 31

Validity 33

Reliability 36

Logistics of Measurement 37

Classification of Health 38

Disease 38

Injuries 40

Functioning and Disability 40

Mental and Behavioral Disorders 41

Quality of Life 41

Other Health Measures 42

Classification of Health Services 42

Classifying Organizational Units 42

Classifying Procedures 43

Control of Measurement Error 43

Sources of Data 44

Chapter 3 Descriptive Epidemiological Measures / Denise M. Oleske 51

Measuring the Frequency of Health Events in Populations 51

Incidence Rate 51

Prevalence Rate 53

Sources of Information for Incidence Rate Measures 54

Sources of Information on Prevalence 55

Format of Descriptive Epidemiological Measures 57

Specific Rates 58

Summary Rates 58

Ratio Measures 64

Chapter 4 Assessing Causality: Foundations for Population-Based Health Care Managerial Decision Making / Thomas T. H. Wan 75

Scientific Inquiry 75

Characteristics of Scientific Inquiry 76

Logic of Scientific Inquiry 77

Stages in Scientific Inquiry 79

Identification and Specification of the Study Problem 79

Selection of an Informed Theoretical Framework 80

Quantification of Study Variables 80

Selection of a Study Design 82

Specification of the Analytic Framework: Proposing the Hypothesis and Setting Error Tolerances 82

Selecting a Statistical Test 84

Multilevel Analysis 87

Evaluating Causality 90

Meta-analysis 92

Chapter 5 Strategic Planning: An Essential Management Tool for Health Care Organizations and Its Epidemiological Basis / Frances J. Jaeger 99

Epidemiological Basis of Strategic Planning 99

Theoretical Basis of Strategic Planning 104

The Strategic Planning Process 106

Step 1. Plan the Planning and Ensure Favorable Conditions for Effective Strategic Planning 107

Step 2. Review the Organization's Mission Statement and Revise It as Necessary to Ensure That It Remains Relevant to the Organization's Future. If No Written Statement of Mission Exists, Develop and Adopt One 107

Step 3. Do a Situational Analysis that Encompasses Assessments of Elements of the Organization's External and Internal Environments as Well as an Evaluation of the Impact of the Organization's Efforts 108

Step 4. Apply an Approach for Defining the Key Issues, Focusing the Attention of the Organization, and Establishing the Framework for the Next Step of Strategy Development 115

Step 5. Generate, Evaluate, and Select Alternative Strategies for Achieving Organizational Goals and Objectives or the Best Alignment of the Organization with the Opportunities in Its Environment 116

Step 6. Carry Out the Implementation Phase of Strategic Planning, Detailing Operational Action Plans and Budgets, Monitoring Impact, and Making Midcourse Adjustments as Necessary 116

Data Resources and Issues Related to Use in Strategic Planning 117

Tools to Facilitate Strategic Planning 117

Applicability of the Strategic Planning Process 119

The Format and Content of the Strategic Plan 122

Chapter 6 Evaluating Health Services, Programs, and Systems: An Epidemiological Perspective / Dolores G. Clement, Thomas T. H. Wan 133

Dimensions of Health System Evaluation 134

Determine the Population Targeted for Intervention 134

Identify Aspects of Health Care To Be Evaluated 134

The Evaluation Process 137

Planning 137

Implementation 138

Intervention 138

Monitoring and Feedback 138

Conceptual Framework for Specifying Evaluation Criteria 138

Analytical Approaches to Evaluation: An Epidemiological Perspective 140

Study Designs 140

Analyzing Intervention Effects 145

Other Analytic Methods 149

Prospects of Health Services Evaluation 150

Specialty Areas

Chapter 7 Epidemiology and Health Care Quality Management / Diane R. Weber, Helen Jo Neikirk, Marcia B. Hargreaves 157

Interrelationship between Health Care Quality Management and Epidemiology 157

Quality Management Defined 158

Organizational Approaches to Quality Management 159

Programmatic Options in Quality Management 159

Quality Planning 160

Performance According to Standards, Guidelines, and Other Management Strategies 161

Performance According to Standards 161

Clinical Practice Guidelines 162

Utilization Management 162

Case Management 163

Risk Management 163

Best Practices 163

Models for Systematic Improvement 164

Plan-Do-Check-Act Model 164

Clinical Value Compass 165

Quality Measurement 166

Process Measures 167

Clinical Outcomes 167

Satisfaction 167

Health Status 168

Data Sources 168

Sampling 169

Levels of Quality Measurement 169

Quality Improvement Tools and Techniques 170

Brainstorming 171

Affinity Diagram 171

Cause-and-Effect Diagram 172

Flowchart 173

Statistical Quality Control Tools 173

Check Sheet 175

Histogram 175

Pareto Chart 175

Scatter Diagram 176

Run Chart and Control Chart 177

Comparison Charts 179

Application of Quality Control Tools 180

Risk Adjustment 181

Chapter 8 Control of Transmissible Diseases in Health Care Settings / Denise M. Oleske, Ronald C. Hershow 191

Infectious Disease Concepts 192

Managing Disease Outbreaks 195

Managerial Responsibilities in Infection Control 196

Bloodborne Disease Transmission 197

Epidemiology of Hepatitis B 198

Epidemiology of Human Immunodeficiency Virus Infection 198

Bloodborne Disease Control Measures 199

Hazard Communication 201

Airborne Disease 203

Airborne Disease Control Measures 204

Special Considerations in Infectious Disease Control for Specific Health Care Service Settings 207

Inpatient Acute Care Facility 207

Ambulatory Care 208

Home Care 209

Long-Term Care/Skilled Nursing Facility 209

Hospice 210

Behavioral Health Care Settings 211

Chapter 9 Genetic Epidemiology: The Basis for a New Health Service Delivery Model / Marcia Phillips, Jack Goldberg 217

Basic Genetic Concepts 218

Mendelian Genetics 218

Exceptions to Mendel's Laws 218

The Human Genome Project 219

Scope and Progress 219

Genetic Mapping 220

Epidemiology and the Human Genome Project 221

International Implications 221

Genetics and Epidemiology 222

Roles of Epidemiology 222

Genetic Techniques and Epidemiology 223

Genetic Epidemiology Studies 225

Health Services Management and Genetic Epidemiology 227

Screening 227

Population-Based Genetic Health Screening Service: Screening for Phenylketonuria, a Model 228

Future of Genetic Screening Programs 229

Economic and Health Impact of Genetic Testing 230

Information Systems Support for Genetic Health Services 230

The Ethical Challenges of Genetics 230

Chapter 10 Technology Assessment / Karl A.

Matuszewski 235

Defining Technology Assessment and Its Function 235

Categories of Technology 237

Devices 237

Procedures 238

Pharmaceuticals 238

Technology Life Cycle 238

Targeting Technologies for Assessment 240

High Utilization 240

High Potential for Harm 241

High Cost 241

How Is Technology Assessment Performed? 241

Literature Review and Synthesis 242

Consensus Panels 243

Decision Criteria 243

Meta-analyses 244

Outcomes Assessment 246

Randomized Clinical Trials 247

Other Methods 247

Who Does Technology Assessment? 248

US Food and Drug Administration 248

Agency for Healthcare Research and Quality 248

American College of Physicians 249

Blue Cross and Blue Shield Association 249

ECRI 249

Center for Practice and Technology Assessment (CPTA) 249

University Health System Consortium 250

Other Assessment Centers 251

International Efforts 251

Problems in Performing Technology Assessment 252

Lack of Evidence 252

Lack of Agreement on How to Perform the Assessment 252

Inconsistent Evidence 252

Legal Interference 252

Breadth of Topics 253

New Information 253

Imperfect Use of Technology 253

Future of Technology Assessment 253

Chapter 11 Health Risks from the Environment: Challenges to Health Service Delivery / Bailus Walker, Jr. 261

Problems in Environmental Health 262

Gene-Environment Interaction 262

Impact of the Environment on the Reproductive System 263

Impact of the Environment on the Immune System 264

Impact of the Environment on the Nervous System 265

Impact of the Environment on the Respiratory System 266

Environmental Terrorism 266

Climate Changes, Cataclysmic Events, and Other Disasters 267

Environmental Equity 269

Global Environmental Health 271

Recognition and Assessment of Environmentally Related Disease 271

Risk Assessment 273

Health Services for Environmentally Provoked Diseases 274

Primary Prevention 274

Secondary Prevention 274

Tertiary Prevention 276

Spanning Topics

Chapter 12 Epidemiology and the Public Policy Process / Iris R. Shannon 285

A Contextual Framework for the Relationship between Public Policy and Epidemiology: Public Health 286

Public Health 286

National Health Objectives 287

Public Policy: An Interactive Process 287

The Interrelationship between Epidemiology and Public Policy 289

Application of Epidemiology in the Policy Process 290

US Department of Health and Human Services Initiative to Eliminate Disparities in Health 290

Infant Mortality 293

Vaccine-Preventable Diseases 294

Childhood Hepatitis B Infections and Hepatitis B Vaccine Use 296

Chapter 13 The Contribution of Epidemiological Information in Economic Decision Making / Gerald L. Glandon 309

Background: Public Goods 310

Government Provision of Public Goods 310

Health Care and Public Goods 311

Overview of the Definition and Core Elements of Cost-Benefit Analysis and Cost-Effectiveness Analysis 312

Cost-Effectiveness Analysis, Epidemiological Data, and Application to Managerial Decision Making 318

Chapter 14 Ethics, Epidemiology, and Health Service Delivery / Sana Loue 329

Approaches to Resolving Ethical Dilemmas 330

Principlism 330

Casuistry 331

Communitarianism 333

Feminist Ethics 334

Utilitarianism 335

Principles, Rules, and Guidelines 338

The Nuremberg Code and Declaration of Helsinki 338

The International Covenant on Civil and Political Rights 339

CIOMS and WHO International Guidelines 340

United States Guidelines and Regulations 340

Operationalizing Codes, Guidelines, and Regulations in the Context of Research and Patient Care 341

Informed Consent 341

Confidentiality and Privacy Concerns 344

Suggested Answers to Selected Case Study Questions 353

Appendix Websites for Health Care Managers Thinking Epidemiologically 373.

Notes:

Previous ed.: New York : Plenum, 1995.

Includes bibliographical references and index.

ISBN:

0306465256

OCLC:

45750513