Top
List of Tables, Figures, and Exhibits xiii
Preface xxiii
The Authors xxvii
1 Epidemiology in Health Care Administration 1
Introduction 2
Philosophical Framework 5
Focus and Uses of Epidemiology 6
Observational Epidemiology • Experimental Epidemiology • Preventive Medicine
Health Care Reform 8
The Concept of Populations and Communities 11
Managing Health Care for Populations and Communities 12
Role of Epidemiology 14
Summary 16
Study Questions 16
2 Description of Health 19
Introduction 20
Health and Disease 21
Definitions • International Classification of Diseases and Related Problems • Health Status
Descriptive Information 25
Person Variables • Place Variables • Time
Other Descriptive Variables 41
Sources of Descriptive Information 43
Vital Statistics • Medical Records
Reportable Diseases 47
Managerial Applications 47
Summary 52
Study Questions 52
3 Measurement of Health 55
Introduction 56
Measures 56
Counts • Rates • Ratios • Proportions
Measuring Morbidity 65
Incidence Rate • Prevalence Rate • Period Prevalence Rate
Measuring Mortality 73
Death Rates • Potential Years of Life Lost
Measuring Health 83
Survival Rate • Health-Related Quality of Life
Other Rates 85
Summary 86
Study Questions 86
4 Studying the Health Needs of Populations 89
Introduction 90
Risk and Causation 91
Study Designs 93
Experimental • Clinical Trials • Observational • Descriptive Studies • Cross-Sectional Studies • Ecological Studies • Prospective Studies • Retrospective Studies
Association of Risk Factors and Health and Disease 103
Measuring Association in Prospective Studies 104
Measuring Association in Retrospective Studies 108
Application to Population Health Management 110
Sampling 113
Summary 115
Study Questions 115
5 Standardizing Population Health Information 117
Introduction 118
Stratification 120
Matching 121
Standardization of Information 123
Direct Method of Standardization • Indirect Method of Standardization
Risk Adjustment 136
Summary 139
Study Questions 140
6 Medical Management in Population Health Care 149
Introduction 150
Medical Management 151
Clinical Effectiveness • Validity • Managerial Aspects of Validity • Reliability • Impact of Test Information • Clinical Practice Analysis
Chronic Disease Management 169
Summary 170
Study Questions 171
7 Management of Infectious Epidemics 175
Introduction 175
Infectious Disease Epidemiology 176
Infectious Epidemics
Health Care–Associated Infections 182
Surveillance 186
Summary 188
Study Questions 188
8 Reimbursement Approaches and Marketing 191
Introduction 192
Reimbursement Methods 193
Current Procedural Terminology • Capitation • Diagnosis-Related Groups • Outpatient Prospective Payment System • Inpatient Rehabilitation Facility Prospective Payment System • Skilled Nursing Facility Prospective Payment System • Home Health Prospective Payment System • Resource-Based Relative Value Scale • Accountable Care Organizations • Pay for Performance
Marketing and Population Health 202
Marketing • The Role of Marketing • Marketing the Health Care System
Market Research 204
Sampling • Market Research Data Analysis • Patient Satisfaction • Demand Estimation • Validity and Reliability of Market Research
Summary 214
Study Questions 215
9 Population Health Outcomes and Quality of Care 219
Introduction 220
Assessing Health Outcomes 220
Health Status Assessment 225
Patient Satisfaction and Patient Expectations Assessment 227
Monitoring Health Outcomes 231
Managing with Health Outcomes 232
Uses of Outcomes Assessment • Benchmarking • Best Practices and Practice Guidelines • Application of Best Practice Assessment • Root Cause Analysis
Quality of Health Care 241
Rapid Improvement Cycle Process • Statistical Process Control • The Malcolm
Baldrige National Quality Program
Summary 250
Study Questions 251
10 Economic Analysis of Health Care for Populations 253
Introduction 254
Economic Evaluation 257
Cost Analysis 259
Cost-Benefit Analysis 261
Cost-Effectiveness Analysis 262
Cost-Utility Analysis 264
Discounting 265
Sensitivity Analysis 269
Burden of Disease Analysis 269
Examples of Economic Analysis 272
Summary 275
Study Questions 276
11 Expanding Hospital Health Care Services 281
Introduction 282
Service Area Population 283
Hospital Care Utilization 284
Discharges 287
Length of Hospital Stay 289
Hospital Description 292
Payment Sources 293
Service Area Population Health 296
12 Long-Term Care 303
Introduction 303
Population Characteristics 304
Westside Elderly Care, Inc. 308
Utilization of Services 308
Staffing 319
13 Emergency Department Services 321
Introduction 321
Emergency Department Utilization 322
Payment Sources 331
Time Analysis 332
Primary Diagnosis at Arrival 336
Patient Disposition 337
14 Physician Practices 341
Introduction 342
Population Characteristics 342
Resource Utilization 343
Time Since Last Visit 346
Insurance Coverage 349
Reason for Visit 351
Preventive Care Visits 355
Chronic Conditions 356
References 359
Index 375
