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| Fundamentals | |
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| An Epidemiological Framework for the Delivery of Health Care Services | |
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| An Epidemiological Model for the Delivery of Health Care Services | |
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| The Population | |
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| Population Trends | |
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| Need for Health Care | |
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| Utilization of Health Care Services | |
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| Factors Affecting Health Care Utilization | |
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| Accessibility of Health Care | |
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| Availability of Health Care Resources | |
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| Health of Populations Served | |
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| Applying Epidemiology in Health Care Management Practice | |
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| Monitoring Service Population Size | |
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| Distribution of Health Needs in a Population | |
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| Understanding the Genesis and Consequences of Health Problems | |
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| Understanding the Relationship between Health System Characteristics and the Health Status of Populations Served | |
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| Monitoring Health Care Systems, Organizations, and Program Performance | |
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| Modifying the Structure and Processes to Respond to Environmental Change | |
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| Formulation and Evaluation of Public Policy Affecting the Delivery of Health Care Services | |
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| Summary | |
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| Case Studies | |
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| References | |
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| Measurement Issues in the Use of Epidemiological Data | |
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| Introduction | |
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| Methods of Measurement | |
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| Validity and Reliability of a Measure | |
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| Validity | |
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| Reliability | |
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| Logistics of Measurement | |
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| Classification of Health | |
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| Disease | |
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| Injuries | |
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| Functioning and Disability | |
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| Mental and Behavioral Disorders | |
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| Quality of Life | |
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| Other Health Measures | |
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| Classification of Health Services | |
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| Classifying Organizational Units | |
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| Classifying Procedures | |
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| Control of Measurement Error | |
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| Sources of Data | |
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| Summary | |
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| Case Studies | |
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| References | |
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| Descriptive Epidemiological Measures | |
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| Measuring the Frequency of Health Events in Populations | |
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| Incidence Rate | |
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| Prevalence Rate | |
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| Sources of Information for Incidence Rate Measures | |
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| Sources of Information on Prevalence | |
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| Format of Descriptive Epidemiological Measures | |
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| Specific Rates | |
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| Summary Rates | |
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| Ratio Measures | |
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| Summary | |
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| Case Studies | |
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| References | |
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| Assessing Causality: Foundations for Population-Based Health Care Managerial Decision Making | |
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| Introduction | |
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| Scientific Inquiry | |
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| Characteristics of Scientific Inquiry | |
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| Logic of Scientific Inquiry | |
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| Stages in Scientific Inquiry | |
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| Identification and Specification of the Study Problem | |
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| Selection of an Informed Theoretical Framework | |
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| Quantification of Study Variables | |
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| Selection of a Study Design | |
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| Specification of the Analytic Framework: Proposing the Hypothesis and Setting Error Tolerances | |
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| Selecting a Statistical Test | |
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| Multilevel Analysis | |
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| Evaluating Causality | |
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| Meta-analysis | |
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| Conclusions | |
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| Case Studies | |
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| References | |
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| Strategic Planning: An Essential Management Tool for Health Care Organizations and Its Epidemiological Basis | |
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| Epidemiological Basis of Strategic Planning | |
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| Theoretical Basis of Strategic Planning | |
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| The Strategic Planning Process | |
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| Plan the Planning and Ensure Favorable Conditions for Effective Strategic Planning | |
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| Review the Organization's Mission Statement and Revise It as Necessary to Ensure That It Remains Relevant to the Organization's Future. If No Written Statement of Mission Exists, Develop and Adopt One | |
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| Do a Situational Analysis that Encompasses Assessments of Elements of the Organization's External and Internal Environments as Well as an Evaluation of the Impact of the Organization's Efforts | |
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| Apply an Approach for Defining the Key Issues, Focusing the Attention of the Organization, and Establishing the Framework for the Next Step of Strategy Development | |
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| Generate, Evaluate, and Select Alternative Strategies for Achieving Organizational Goals and Objectives or the Best Alignment of the Organization with the Opportunities in Its Environment | |
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| Carry Out the Implementation Phase of Strategic Planning, Detailing Operational Action Plans and Budgets, Monitoring Impact, and Making Midcourse Adjustments as Necessary | |
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| Data Resources and Issues Related to Use in Strategic Planning | |
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| Tools to Facilitate Strategic Planning | |
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| Applicability of the Strategic Planning Process | |
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| The Format and Content of the Strategic Plan | |
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| Conclusions | |
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| Case Studies | |
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| References | |
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| Evaluating Health Services, Programs, and Systems: An Epidemiological Perspective | |
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| Dimensions of Health System Evaluation | |
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| Determine the Population Targeted for Intervention | |
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| Identify Aspects of Health Care To Be Evaluated | |
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| The Evaluation Process | |
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| Planning | |
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| Implementation | |
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| Intervention | |
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| Monitoring and Feedback | |
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| Conceptual Framework for Specifying Evaluation Criteria | |
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| Analytical Approaches to Evaluation: An Epidemiological Perspective | |
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| Study Designs | |
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| Analyzing Intervention Effects | |
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| Other Analytic Methods | |
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| Prospects of Health Services Evaluation | |
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| Conclusion | |
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| Case Studies | |
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| References | |
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| Specialty Areas | |
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| Epidemiology and Health Care Quality Management | |
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| Introduction | |
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| Interrelationship between Health Care Quality Management and Epidemiology | |
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| Quality Management Defined | |
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| Organizational Approaches to Quality Management | |
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| Programmatic Options in Quality Management | |
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| Quality Planning | |
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| Performance According to Standards, Guidelines, and Other Management Strategies | |
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| Performance According to Standards | |
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| Clinical Practice Guidelines | |
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| Utilization Management | |
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| Case Management | |
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| Risk Management | |
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| Best Practices | |
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| Models for Systematic Improvement | |
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| Plan-Do-Check-Act Model | |
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| Clinical Value Compass | |
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| Quality Measurement | |
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| Process Measures | |
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| Clinical Outcomes | |
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| Satisfaction | |
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| Health Status | |
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| Data Sources | |
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| Sampling | |
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| Levels of Quality Measurement | |
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| Quality Improvement Tools and Techniques | |
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| Brainstorming | |
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| Affinity Diagram | |
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| Cause-and-Effect Diagram | |
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| Flowchart | |
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| Statistical Quality Control Tools | |
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| Check Sheet | |
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| Histogram | |
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| Pareto Chart | |
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| Scatter Diagram | |
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| Run Chart and Control Chart | |
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| Comparison Charts | |
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| Application of Quality Control Tools | |
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| Risk Adjustment | |
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| Conclusion | |
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| Case Studies | |
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| References | |
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| Control of Transmissible Diseases in Health Care Settings | |
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| Introduction | |
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| Infectious Disease Concepts | |
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| Managing Disease Outbreaks | |
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| Managerial Responsibilities in Infection Control | |
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| Bloodborne Disease Transmission | |
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| Epidemiology of Hepatitis B | |
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| Epidemiology of Human Immunodeficiency Virus Infection | |
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| Bloodborne Disease Control Measures | |
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| Hazard Communication | |
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| Airborne Disease | |
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| Airborne Disease Control Measures | |
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| Special Considerations in Infectious Disease Control for Specific Health Care Service Settings | |
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| Inpatient Acute Care Facility | |
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| Ambulatory Care | |
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| Home Care | |
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| Long-Term Care/Skilled Nursing Facility | |
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| Hospice | |
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| Behavioral Health Care Settings | |
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| Conclusion | |
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| Case Studies | |
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| References | |
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| Genetic Epidemiology: The Basis for a New Health Service Delivery Model | |
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| Introduction | |
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| Basic Genetic Concepts | |
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| Mendelian Genetics | |
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| Exceptions to Mendel's Laws | |
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| The Human Genome Project | |
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| Scope and Progress | |
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| Genetic Mapping | |
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| Epidemiology and the Human Genome Project | |
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| International Implications | |
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| Genetics and Epidemiology | |
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| Roles of Epidemiology | |
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| Genetic Techniques and Epidemiology | |
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| Genetic Epidemiology Studies | |
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| Health Services Management and Genetic Epidemiology | |
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| Screening | |
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| Population-Based Genetic Health Screening Service: Screening for Phenylketonuria, a Model | |
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| Future of Genetic Screening Programs | |
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| Economic and Health Impact of Genetic Testing | |
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| Information Systems Support for Genetic Health Services | |
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| The Ethical Challenges of Genetics | |
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| Conclusion | |
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| Case Studies | |
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| References | |
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| Technology Assessment | |
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| Defining Technology Assessment and Its Function | |
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| Categories of Technology | |
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| Devices | |
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| Procedures | |
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| Pharmaceuticals | |
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| Technology Life Cycle | |
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| Targeting Technologies for Assessment | |
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| High Utilization | |
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| High Potential for Harm | |
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| High Cost | |
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| How Is Technology Assessment Performed? | |
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| Literature Review and Synthesis | |
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| Consensus Panels | |
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| Decision Criteria | |
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| Meta-analyses | |
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| Outcomes Assessment | |
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| Randomized Clinical Trials | |
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| Other Methods | |
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| Who Does Technology Assessment? | |
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| US Food and Drug Administration | |
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| Agency for Healthcare Research and Quality | |
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| American College of Physicians | |
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| Blue Cross and Blue Shield Association | |
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| ECRI | |
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| Center for Practice and Technology Assessment (CPTA) | |
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| University Health System Consortium | |
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| Other Assessment Centers | |
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| International Efforts | |
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| Problems in Performing Technology Assessment | |
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| Lack of Evidence | |
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| Lack of Agreement on How to Perform the Assessment | |
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| Inconsistent Evidence | |
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| Legal Interference | |
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| Breadth of Topics | |
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| New Information | |
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| Imperfect Use of Technology | |
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| Future of Technology Assessment | |
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| Summary | |
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| Case Studies | |
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| References | |
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| Health Risks from the Environment: Challenges to Health Service Delivery | |
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| Introduction | |
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| Problems in Environmental Health | |
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| Gene-Environment Interaction | |
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| Impact of the Environment on the Reproductive System | |
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| Impact of the Environment on the Immune System | |
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| Impact of the Environment on the Nervous System | |
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| Impact of the Environment on the Respiratory System | |
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| Environmental Terrorism | |
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| Climate Changes, Cataclysmic Events, and Other Disasters | |
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| Environmental Equity | |
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| Global Environmental Health | |
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| Recognition and Assessment of Environmentally Related Disease | |
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| Risk Assessment | |
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| Health Services for Environmentally Provoked Diseases | |
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| Primary Prevention | |
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| Secondary Prevention | |
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| Tertiary Prevention | |
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| Summary and Conclusion | |
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| Case Studies | |
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| References | |
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| Spanning Topics | |
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| Epidemiology and the Public Policy Process | |
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| A Contextual Framework for the Relationship between Public Policy and Epidemiology: Public Health | |
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| Public Health | |
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| National Health Objectives | |
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| Public Policy: An Interactive Process | |
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| The Interrelationship between Epidemiology and Public Policy | |
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| Application of Epidemiology in the Policy Process | |
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| US Department of Health and Human Services Initiative to Eliminate Disparities in Health | |
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| Infant Mortality | |
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| Vaccine-Preventable Diseases | |
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| Childhood Hepatitis B Infections and Hepatitis B Vaccine Use | |
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| Summary | |
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| Case Studies | |
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| References | |
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| The Contribution of Epidemiological Information in Economic Decision Making | |
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| Introduction | |
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| Background: Public Goods | |
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| Government Provision of Public Goods | |
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| Health Care and Public Goods | |
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| Overview of the Definition and Core Elements of Cost-Benefit Analysis and Cost-Effectiveness Analysis | |
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| Cost-Effectiveness Analysis, Epidemiological Data, and Application to Managerial Decision Making | |
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| Conclusion | |
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| Case Studies | |
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| References | |
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| Ethics, Epidemiology, and Health Service Delivery | |
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| Introduction | |
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| Approaches to Resolving Ethical Dilemmas | |
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| Principlism | |
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| Casuistry | |
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| Communitarianism | |
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| Feminist Ethics | |
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| Utilitarianism | |
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| Principles, Rules, and Guidelines | |
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| The Nuremberg Code and Declaration of Helsinki | |
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| The International Covenant on Civil and Political Rights | |
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| CIOMS and WHO International Guidelines | |
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| United States Guidelines and Regulations | |
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| Operationalizing Codes, Guidelines, and Regulations in the Context of Research and Patient Care | |
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| Informed Consent | |
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| Confidentiality and Privacy Concerns | |
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| Conclusions | |
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| Case Studies | |
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| References | |
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| Suggested Answers to Selected Case Study Questions | |
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| Websites for Health Care Managers Thinking Epidemiologically | |
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| Glossary | |
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| Index | |