Foreword

    Here is the first version of the textbook for our course "Public Health Policy and Management" (MPHP 439) which is part of the new Masterís degree program in Public Health at Case Western Reserve University.  It has been written collectively by all the class participants during the winter 2000 session of this course.  This is the first time this course has been offered.  You can judge for yourself the high quality of their work.
The authors collectively prioritized chapter topics and reviewed the progress of each otherís work.

    The content of this course focuses on professionals who participate in the management of population-based health care, whether it be a public health department, an HMO, a regional government health service or a clinic with responsibility for the health of a defined population.  Such a person needs to know the following.   They need to understand the health care system, its component parts and relationships between them.  They need to have theories about how this world works, including health economics, political science, organization theory and social psychology.  They need to have the skills and perspective of health care managers, including decision making, leadership, cost analysis and budgeting, marketing, public relations, continuous quality improvement and understanding the scientific method applied to clinical care.  In the course these concepts are taught using the case method and associated readings.  The texts used are: Kovner, Anthony, Neuhauser, Duncan, Health Systems Management: A Book of Readings, (now in its seventh edition) and a companion Book of Cases (now in its sixth edition).  Chicago, Health Administration Press, 2000.  You can see that this course covers a vast ground.  It is comparable to teaching all medical school or all law school in one graduate course.  The only justification for this is to view this course as but one step in a process of life long learning.  For this reason the final exam for the course was for each participant to define their plans for continued learning in public health management or if one has no aspiration in this direction to continue learning in other areas such as research or clinical practice.  One test of this willingness to continue beyond the course will be to see how many participants update their chapters after the course is over and how many will return to check out future revisions.
We expect to expand and revise this online textbook yearly with each new class and continue to make it available on the internet.  We grant you permission to download and copy this text without charge.  However, we would all like to know if and how you plan to use it.  We welcome your suggestions.

    Writing an online textbook for all the world to see puts more pressure on participants to do a good job compared to simply writing a paper for a course grade.  Perhaps future prospective employers may check out their work.  These authors in the process of doing this became a cohesive self organizing group.  This included two lengthy group dinners at local restaurants and social functions after the course finished.
In my international work I have come to realize the value of free online textbooks for many parts of the world which cannot afford regular textbooks.  In a country with the yearly per capita income of $500, the cost of a $50 textbook is too much even for one copy in the Ministry of Healthís national library.  Our students here certainly appreciate free text books regularly updated with life long access to it.  It is an exciting idea.  By forgoing a few dollars in royalties, one can create a free text that can be used by tens of thousands of students around the world.  Our group challenges other universities, faculty and students to do the same or even do it better.

    As a teacher, it is my honor and privilege to be part of the group that has created this text in its first edition.

Duncan Neuhauser, Ph.D.
The Charles Elton Blanchard, MD Professor of Health Management
Department of Epidemiology and Biostatistics
Case Western Reserve University
10900 Euclid Avenue
Cleveland, OH 44106-4945
Phone: (216) 368-3726
Fax: 2166-368-3970
E-mail: dvn@po.cwru.edu
 
November 2002
Introduction to the Third Edition

    Welcome to the Third Edition of the On-Line textbook!

    Over the years the On-Line Textbook has grown in breadth and quality.  This edition you will note a significant development in the area of public health issues among special populations including Adolescents, American Indians and Alaskan Natives, Immigrants and Refugees, Mentally Ill, Women, the Uninsured and Underinsured.  There is also an expansion of foundational and applied topics, as well as special attention to issues of emerging infectious disease and bioterrorism. 

    As a class we have sought a variety of means to improve the quality and distribution of this resource.  Initiatives to build an internal editorial board and formalize major categories/topics for the text book were discussed.  In addition a Public Relations committee was organized which mobilized a marketing campaign that included printing business cards with our web address, to be handed out by students and faculty in the department.  Our hope is that with each successive year the success and achievements of the students that preceded can be build upon.

    Please have a good look around, and let us know what you think!  Also please visit us frequently as we are also planning to connect this website with other similar public health on-line textbooks internationally!  A variety of links just below the Table of Contents can guide you peruse these and other exciting projects.

Kathryn Barzilai, RN

MSN/PhD Student, Case Western Reserve University

May 16, 2000

Introduction to the First Edition

    This online textbook addresses the issues related to health services management and public policy. Healthcare is filled with an abundance of economic and quality issues. Accordingly, the practice of medicine has become quite complex. By taking a piece of paper and folding it many times to produce a paper sculpture, a multi-faceted origami is produced. Similarly, the evolution of the practice of medicine from a one-provider to one-patient approach to an evidence-based population-based patient-centered multidisciplinary team practice has unfolded. The topics addressed in this book help provide insight into the issues of modern healthcare and assist in reducing the disease burden of a population within the confinement of fiscal constraints.
  We look to information technology for healthcare quality measurement and improvement. We take health promotion to the people at the workplace. We take the message to the people via mass communications. We encourage the population to access the message via the internet. These are just some of the issues addressed in this textbook. This knowledge helps us to manage disease more, and thus, disease manages us less.
  The healthcare environment is in a constant state of change. We must be vigilant in our goal to optimize the interaction between a healthcare organization and its environment. The task is never complete. To quote Sun Tzu in The Art of War, which was written over two thousand years ago,  "As water shapes its flow in accordance with the ground, so an army manages its victory in accordance with the situation of the enemy. And as water has no constant form, there are in war no constant conditions."
  We plan to expand and update this textbook periodically at regular intervals.

Mark A. Best, MD, MBA
MPH student, Case Western Reserve University
Quality Scholar, VA Quality Scholars Fellowship Program, Cleveland VA Medical Center
Cleveland, OH