Abstract
The evaluation of health care is vitally important to our efforts directed at reforming and improving the performance of our health care system. Evaluation is a means by which a program or a process is examined and an informed judgment is made concerning the extent of success in reaching predetermined goals. Evaluation plays two major roles in health care: (1) assuring the delivery of high quality care, and (2) providing a tool for controlling costs and promoting accountability for public program expenditures. Evaluation is not merely the application of methods; it involves managerial and political decision making pertinent to the allocation of resources to other functions such as program planning, design, implementation, and ongoing monitoring. Evaluations are done for a variety of purposes: to improve the delivery of care, to test an innovation, to determine the effectiveness of regulatory policy, or to assess the appropriateness of continuing or altering an intervention. The use of epidemiologic principles and methods in the evaluation process can clarify information required for program development or guide decisions relevant to continued operations. In addition, epidemiology provides measures, analytic study designs, and methods for investigating the effectiveness of programs in controlling disease, disability, and other health problems and for measuring their consequences in populations receiving health care services.
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References
Anderson, S., Auquier, A., Hauck, W. W., Oakes, D., Vandaele, W., and Wersberg, H. I., 1980, Statistical Methods for Comparative Studies, John Wiley & Sons, New York.
Bennett, C. L., Garfinkle, J. B., Greenfield, S., Draper, D., Rogers, W., Mathews, C., and Kanouse, D. E., 1989, The relation between hospital experience and in-hospital mortality for patients with AIDS-related PCP, JAMA 261:2975–2979.
Bibeau, D., Mullen, K., McLeroy, K., Green, L., and Foshee, V., 1988, Evaluations of workplace smoking cessation programs: A critique, Am. J. Prey. Med. 4:87–95.
Bollen, K., 1989, Structural Equations with Latent Variables,John Wiley & Sons, New York.
Box, G. E. P., and Jenkins, G. M., 1976, Time Series Analysis: Forecasting and Control, Holden-Day, San Francisco.
Carlisle, D. M., Siu, A., Keeler, E. B., McGlynn, E. A., Kahn, K. L., Rubenstein, L. V., and Brook, R. H., 1992, HMO vs. fee-for-service care of older persons with acute myocardial infarction, Am. J. Public Health 82:1626–1630.
Cox, D. R., Regression models and life-tables, J. R. Statist. Soc. B34:187–220.
Donabedian, A., 1980, Explorations in Quality Assessment and Monitoring,Vol. I: The Definition of Quality and Approaches to Its Assessment, Health Administration Press, Ann Arbor, MI.
Donabedian, A., 1981, Advantages and limitations of explicit criteria for assessing the quality of health care, Milbank Mem. Fund Q. Health Soc. 59:99–106.
Greenlick, M. R., 1981, Assessing clinical competence: A society view, Eval. Health Professions 4:3–12.
Health Care Financing Administration, 1992, Medicare Hospital Information, U.S. Government Printing Office, Washington, DC.
Hedrick, S. C., Koepsell, T. D., and Inui, T., 1989, Meta-analysis of home-care effects on mortality and nursing-home placement, Med. Care 27:1015–1026.
Joreskog, K. G., and Sorbom, D., 1993, Lisrel 8 with Prelis 2, Scientific Software International, Chicago.
Kahn, H. A., and Sempos, C. T., 1989, Statistical Methods in Epidemiology,Oxford University Press, New York.
Kaplan, E. L., and Meier, R, 1958, Nonparametric estimation from incomplete observations, J. Am. Statist. Assoc. 53:457–481.
Knaus, W. A., Draper, E. A., and Wagner, D. R, 1983, Toward quality review in intensive care: The APACHE system, Quality Rev. Bull. 9:(7):196–204.
Kotchen, J. M., McKean, H. E., Jackson-Thayer, S., Moore, R. W., Straus, R., and Kotchen, T., 1986, Impact of a rural high blood pressure control program on hypertension control and cardiovascular disease mortality, JAMA 255:2177–2182.
Lane, D. S., Polednak, A. R, and Burg, M. A., 1992, Breast cancer screening practices among users of county-funded health centers vs. women in the entire community, Am. J. Public Health 82:199–203.
Levy, R. S., and Lemeshow, S., 1980, Sampling for Health Professionals, Lifetime Learning, Belmont, CA.
National Institute on Drug Abuse, 1985, National Household Survey on Drug Abuse: 1985 Population Estimates, National Institute on Drug Abuse, Rockville, MD.
Okada, L. M., and Wan, T. T. H., 1980, Impact of community health centers and Medicaid on the use of health services, Public Health Rep. 95:520–534.
Retchin, S. M., and Brown, B., 1990, The quality of ambulatory care in Medicare health maintenance organizations, Am. J. Publ. Health 80:411–415.
Rogers, P. N., and Schoenig, S. E., 1993, A time series evaluation of California’s 1982 driving-under-the-influence legislative reforms, Accid. Anal. Prey. 26:63–78.
Rooks, J. P., Weatherby, N. L., Ernst, E., Stapleton, S., Rosen, D., and Rosenfield, A.,1989, Outcomes of care in birth centers, N. Engl. J. Med. 321:1804–1811.
Rosen, H. M., and Feigin, W., Sr., 1983, Quality assurance and data feedback, Health Care Manage. Rev. 8:67–74.
Sackett, D. L., 1979, Bias in analytic research, J. Chron. Dis. 32:51–63.
Vogt, T. M., and Schweitzer, S. O., 1985, Medical costs of cigarette smoking in a health maintenance organization, Am. J. Epidemiol. 122:1060–1066.
Wan, T. T. H., 1992, Hospital variations in adverse patient outcomes, Qual. Assur. Util. Rev. 7:50–53.
Wan, T. T. H., Weissert, W. G., and Livieratos, B. B., 1980, Geriatric day care and homemaker services: An experimental study, J. Gerontol. 35:256–274.
Warner, K., and Luce, B. R., 1982, Cost—Benefit and Cost—Effectiveness Analysis in Health Care: Principles, Practice, and Potential, Health Administration Press, Ann Arbor, MI.
Wolinsky, F. D., and Johnson, R. J., 1991, The use of health services by older adults, J. Gerontol. 46:S345–357.
Young, G. J., and Cohen, B. B., 1991, Inequities in hospital care, the Massachusetts Experience, Inquiry 28:255–262.
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Clement, D.G., Wan, T.T.H., Stegall, M.H. (1995). Evaluating Health Care Programs and Systems. In: Oleske, D.M. (eds) Epidemiology and the Delivery of Health Care Services. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1839-6_5
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DOI: https://doi.org/10.1007/978-1-4615-1839-6_5
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