An epidemiological model for health policy analysis

Abstract

Health programs needing health and other related data have failed in their solutions because they have lacked a rational framework for analysis. A cursory analysis of present disease patterns reveals chronic conditions for which the present system of organized health care has no immediate cures. On the other hand, infectious diseases of decades past have been all but eliminated by vaccines and antibiotics. Before we are able either to prevent or to arrest current disease processes, we must dissect the health field into more manageable elements that reflect a creative area for epidemiological models. An epidemiological model that supports health policy analysis and decisiveness must be broad, comprehensive, and must include all matters affecting health. Consequently, four primary divisions have been identified: (1) System of Health Care Organization; (2) Life Style (self-created risks); (3) Environment; and (4) Human Biology. An application of the epidemiological model involves four steps: (1) the selection of diseases that are of high risk and that contribute substantially to the overall morbidity and mortality; (2) to proportionately allocate the contributing factors of the disease to the four elements of the epidemiological model; (3) to proportionately allocate total health expenditures to the four elements of the epidemiological model; and (4) to determine the difference in proportions between (2) and (3) above. Five tables illustrate how the epidemiological model is applied, showing the diseases selected for analysis; the contributing factors of each disease to the four components of the epidemiological model; the distribution of Federal outlays for medical and health-related activities by category; the distribution of Federal outlays of health expenditures by category; and a comparison of Federal health expenditures to the allocation of mortality in accordance with the epidemiological model. The conclusion to be drawn from this study is that, based on current procedures for reducing mortality and morbidity, little or no change in our present disease patterns will be accomplished unless we dramatically shift our health policy. © 1976 D. Reidel Publishing Company.