Evaluating Health Care Programs and Systems
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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