In the previous edition of this book, the predominant theme was applying epidemiology to
assist managers in dealing with an environment in which the structure of health care financing
was rapidly changing to managed care and in which there was increasing competition among
health care providers. While these phenomena continue to exist, new challenges have
emerged, and in particular the explosion of information technology has given way to a global
society and decision making that is increasingly shared with consumers because of their access
to the same sets of data. Thus, the questions with which health care managers are confronted
on a daily basis are now exceedingly more complex: (1) How can a population be defined
considering that both exposures and diseases originating in one corner of the globe can rapidly
become a threat to any nation’s security? (2) Where do influences on a population begin and
end? (3) How can we protect and promote health in that population or any population if
privacy is preeminent?
This edition brings in this editor’s view of the increasing need for health care managers,
be they in private or public settings, to use epidemiological concepts and methods. The challenges
posed by health care delivery in the 21st century are immense, ranging from redefining
life and health given the advances in genetic technology, global environmental changes, and
multinational simultaneous increases in poverty and longevity, to economic decisions regarding
technology and service levels that fewer and fewer can afford. Epidemiology, as the
language of science, is the essential tool in health care management decision making, be it at
the point of direct service or at the level of deciding national priorities in a limited health care
budget.