Letters to the Editor
To the Editor:
Given that the overarching goal of health care reform is to improve the health of our population, the focus of health services management (as well as clinical practice) should be on the health of the populations they serve and not solely the fiscal health of their institutions.1 For this reason, I maintain that the science of public health management, namely managerial epidemiology, is the evaluation tool of choice. It is that branch of epidemiology that utilizes the traditional quantitative and causal reasoning methods taught in medical schools. It also incorporates the business aspects of health care that monitor demand, delivery, clinical outcome measurement, resource allocation, strategic analysis, program planning, and managed care. With 30 million more people in our health care system, we need to refine further our ability to provide equitable care while containing costs and ultimately reducing the demand for health care. Managerial epidemiology is “the scientific basis for any health system reform”2 and is the science that must pervade professional preparation in both clinical and management practice.
Our health care leaders and providers need to be change agents in aligning social and economic objectives so that the improvement of population health is the prime metric of success. Integrating public health and personal health care policy and services is the silent and significant challenge. Distinctively, managerial epidemiology can measure the effectiveness of our newly revised system. It can tell us whether our reformed health care system is any more effective in improving the human condition. It is the metric to assess the implications of health care reform.
Rosemary M. Caron, PhD, MPH
Associate professor, University of New Hampshire, Durham, New Hampshire, and chair-elect, Association for University Programs in Health Administration, Public Health Faculty Network; firstname.lastname@example.org.
1 Evans RG. Healthy populations or healthy institutions: The dilemma of health care management. J Health Admin Educ. 1995;13:453–472.
2 Roper WL, Cates WC. Managerial epidemiology: The basic science for health reform. J Health Admin Educ. 1993;11:621–627.