Managerial Epidemiology for Health Care Organizations, 3rd Edition [Rental Edition]

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

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