Oleske D M
Department of Health Systems Management, Rush University, Chicago, IL 60612.
J Health Adm Educ. 1993 Fall;11(4):531-9.
Historically, in the United States, the practice of most epidemiologists has been oriented toward the public health needs of persons living in communities, and has focused on the determination of rates of disease, risk factors for disease, and evaluating prevention and screening efforts. Continuous profound changes in demographic patterns throughout the world, increases in the rates of many chronic and communicable diseases and disabling conditions, and payer constraints all test the ability of health systems managers to provide quality health care. Over time, managers of health systems will recognize that the most cost-effective strategies will be derived from a population-based perspective. With this viewpoint, the epidemiologist can be a pivotal link in assisting the management team to align the delivery of health care services more effectively with the needs of populations targeted for services, either those residing in communities or those currently receiving services by a system, organization, or an individual provider. This article will describe the increasing role of the epidemiologist in health care organizations and illustrate the functions of the epidemiologist on the health care management team based upon the author's own experience at Rush-Presbyterian-St. Luke's Medical Center, an academic health care center in Chicago, Illinois.
从历史上看，在美国，大多数流行病学家的工作一直围绕社区居民的公共卫生需求展开，重点在于确定疾病发病率、疾病风险因素以及评估预防和筛查工作。全球人口结构持续发生深刻变化，许多慢性病、传染病和致残性疾病的发病率不断上升，以及支付方的限制，都对卫生系统管理者提供优质医疗服务的能力构成了考验。随着时间的推移，卫生系统管理者将认识到，最具成本效益的策略将源自基于人群的视角。从这个角度来看，流行病学家可以成为关键纽带，协助管理团队更有效地使医疗服务的提供与目标服务人群的需求相匹配，这些人群既可以是居住在社区的居民，也可以是目前正在接受某个系统、组织或个体提供者服务的人群。本文将描述流行病学家在医疗保健组织中日益重要的作用，并根据作者本人在伊利诺伊州芝加哥的学术医疗中心拉什 - 长老会 - 圣卢克医疗中心的经验，阐述流行病学家在医疗保健管理团队中的职能。
