Managerial Epidemiologist

Chapter 5: Quality of Care MeasurementWhat is the importance of determining disease rates and having a comprehensive surveillance program?Why is it important to do surveillance of noninfectious outcomes of care?With respect to the Risk-Adjusted Complication Rates in a Small Rural Hospital case study, why might you expect the complications measure to be higher for the large and/or teaching hospital?What are some plausible explanations for the risk-adjusted complications rates at the Boondocks Hospital? What kinds of action should the hospital take?What are quality indicators? What is total quality management? Why do these concepts matter in a health care setting?Chapter 6: Mortality and Risk AdjustmentWhat are the major parts of a mortality rate?What does it mean to compare mortality rates across time, place and person?What are risk-adjusted mortality rates? Standardization of mortality rates?In the case of the State of Pennsylvania, how do the statewide mortality rates compare along each of the three dimensions?What is the expected mortality rate for congestive heart failure for Hospital A?What additional information is necessary to calculate an SMR?Using the State of New York case study, which factors are supposedly related to CABG mortality? Which factors are most strongly related to CABG mortality?Chapter 7: Descriptive Epidemiology: Time, Place, PersonHow do age, race, gender, socioeconomic status associated with disease?What are modifiable risk factors?What is descriptive epidemiology?Relative to the HIV Clinics in Kentucky case study, what criteria should be used to locate a new clinic?Are there other criteria and data not presented in the case study that would help locate a new clinic?Chapter 8: Epidemiology and Financial ManagementIs healthcare deliver reactive or proactive? Explain. What is the role of epidemiology in finance?What is capitation? In your answer, include the basics as well as risk adjustment. How are capitation rates adjusted?What is pay for performance? Does it work? Why or why not?Chapter 9: Cost-Effective AnalysisWhat are cost-effective rations? A cost-effective model?How do health care leaders/managers measure effectiveness?What are quality-adjusted life years?How are costs measured?What are biased estimates?What is a cost-benefit analysis?In the Cost-Effectiveness of Health Insurance case study, what is the relationship between expenditures and age from both the insured and uninsured groups?What is the relationship between quality of life, mortality and age from both the insured and uninsured groups?Chapter 10: Evidence-Based Management and MedicineWhat is evidence-based medicine?What are levels of measurement?What is the difference between descriptive and inferential epidemiology?Distinguish between descriptive and inferential statistics?What are confidence intervals? How are they used in epidemiology?What is a two-sample t-test? How is this test used in statistics and epidemiology?Chapter 11: Case Control StudiesHow are cases and controls selected?What is relative risk? Exposure?What is a confounding variable?What is bias in a research study? What are some of the sources of bias in epidemiologic studies?What is a cross-sectional study?Chapter 12: Cohort StudiesWhat is a cohort study?How are cohorts selected?In the Scottish Heart Study case study, does dietary fiber appear to be more protective against CHD risk or against non-CHD death?The authors do not detail the causes of the ‘non-CHD death. ’ Speculate about what those causes could be and what they might have to do with dietary fiber. If the 95 percent confidence interval for ‘CHD case’ was (8. 1, 9. 6) instead of (8. 1, 8. 6), how would it affect the conclusions?How is incidence measured?In the Smoking and Prostate Cancer case study, what is the odds ratio for the risk of prostate cancer with smoking?What are the sampling fractions for exposed and unexposed controls?What are the advantages and disadvantages of cohort studies?Chapter 13: Randomized Clinical TrialsWhat is randomization?8Describe the methods of randomized clinical trials?How is sample size determined?What are some ethical considerations when conducting randomized clinical trials?What is a factorial design?In the RAND Health Insurance Experiment case study, what kind of factors is the randomization process likely to control for in this study?How do you interpret the results of this study with regard to the effect of cost sharing on utilization?Why would this RCT design be better than a cohort study of groups with different co-insurance rates?What is a meta-analysis? Community trials?Chapter 14: Clinical Epidemiology and Decision Making What is causality and how is it determined?What are primary, secondary, tertiary prevention? Give examples of each. As health care professionals, how does one determine cost-effectiveness in medicine?What is the future of primary care and prevention? Does prevention really work? Explain. In the Clinical Decision-Making Toolbox case study, what are the positive and negative likelihood ratios associated with this test?What are the pretest odds that Bob Brown has heart disease?How does this test help Dr. Skeptic make his diagnosis?Chapters 15-17: Epidemiology and Specific DiseaseExplain the epidemiology of cardiovascular disease. What are the trends in CVD mortality?Describe geographic variations in CVD. As a health care professional, what recommendations would you make the combat CVD regionally? (you may select one region for this question). Include strategies for prevention. What are some managerial and economic considerations that should be made with respect to CVD screening? What are some considerations for screening tests generally?Twenty years ago, an HIV diagnosis meant a death sentence. Since that time, we have available a number of treatment options. What have the trends been in terms of HIV mortality?How prevalent is HIV now? Are there individuals at higher risk than others? Explain. What are some of the study designs u8sed to examine HIV risk factors?Name some of the risk factors for Alzheimer’s disease. Discuss the prevalence, incidence and mortality of the disease. What are some of the management costs of the disease? Management implications?What are some of the challenges to studying Alzheimer’s disease from an epidemiologic perspective?

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