[Health systems as an epidemiological topic--or how do we know how effective health systems are?].
The article looks at health systems -- especially their effectiveness in improving population health -- from an epidemiological perspective. It demonstrates that research questions and methodologies do not substantially differ from other areas of epidemiological research. Longitudinal designs are superior to the frequently conducted cross-sectional approaches; exposition and outcome parameters need to be carefully defined. A useful approach is "avoidable mortality" which separates medically amenable causes of death from other ones. The article demonstrates that the "exposition health system" has a clearly beneficial effect on population health.
Busse
R
R
Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Sekr. EB2, Strasse des 17. Juni 145, 10623 Berlin. rbusse@tu-berlin.de
D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D006296:Health Services / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006801:Humans; D009026:Mortality; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000458:organization & administration; D012107:Research Design