Evaluation of Health Service Programs and Levels of Measurement

OR a hundred years or more clinical medicine has applied, with varying degrees of sophistication and rigor, the method of the controlled clinical trial to test the effectiveness or value of proposed new therapies for individual patients (1). Only in the last decade or two has serious attention been given to evaluation of the various forms of organization of health services. The problems of this type of evaluation are complicated by an admixture of variables, especially involving differences between the test and control, or comparison, groups with respect to the characteristics of the persons served, the medical technology applied, or other factors outside of the form or pattern of health service organization per se.