Epidemiology and health services administration: future relationships in practice and education

Abstract

Florence Nightingale's mid-nineteenth century proposals for standard classification of diseases were a model for assessing quality of hospital care. A century later, health planning, management, and evaluation are still in pursuit of her unrealized--and imperfect--objectives. Historical, statistical, and epidemiological limitations to linking the cost and outcome of treating patients and populations are examined; an integrated model is offered for operational rapprochement between medical and administrative services.