Pad 601 Health Services & Hospitals Administration Dr. Hussein M Borie د/ حسين محمد برعي

1. Pad 601Health Services & Hospitals Administration Dr. Hussein M Borieد/ حسين محمد برعي hborai@yahoo.com 0555601637 H.M. BORIE

2. MANAGINGHEALTHSERVICESORGANIZATIONS By Jonathon S. Rakich , B . B . Longest , & Kurt Darr H.M. BORIE

3. PAD 601Health Services & Hospitals Administration Dr. Hussein .M. BorIEIntroduction about the course :CONTENTS PAD 601 • Introduction about the course : Pad 601 • * The contents : Parts 1 & 2 * • Management and managers (Ch.1) • Health Care Delivery Systems(Ch.2) • Concepts of Organization Design(Ch.3) • Health Services Organizations(Ch.4) • Health SERVICES Technology(Ch.6) H.M. BORIE

4. Contents • Organizational Change(Ch.12) • PROBLEMS SOLVING & DECISIONS MAKING(Ch.7) • Health Services Strategic Planning( Ch.8) • COMMUNICATION ( Ch.17)

5. Healthcare Systems • Major Definitions • Conceptual Definitions • Operational Definitions • Healthcare Systems • Health and System Goals • International Health Care Systems • Comparative Health Care Systems • What Makes a Good Healthcare System H.M. BORIE

6. HEALTH or HEALTHCARE • Traditionally, health has been viewed as the absence of disease, and healthcare as the treatment and increasingly the prevention of disease. • In most countries, the traditional focus of the Department of Health has been to manage illness rather to achieve health. • Health services alone do not determine human health. H.M. BORIE

7. What is Health ? • Health is a complex and multidimensional issue . • Many of the factors influencing over all health either not in the traditional domain of health care or are difficult to influence , e.g.: Water quality , diet , genetics , and consumption of tobacco & other…….. H.M. BORIE

8. DEFINITION of WHO ? • Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. • Historically, all the great advances in health have been caused by prevention of diseases. H.M. BORIE

9. What is HEATH CARE System? The system Concept A system is set of components that are related in the accomplishment of some purpose. In the study of healthcare administration, our principal concern is healthcare systems ; that is , systems composed of human beings , money , materials , equipment , and so on , which are related in the accomplishment of some goal , or goals . Healthcare systems are essentially social systems ( in the attitudes , perceptions , motivations , and expectations of human beings ) . H.M. BORIE

10. Components of Healthcare Systems • Consist of a number of interrelated subsystems . • Each of these subsystems has a purpose which, if attained, aids the larger system in reaching its overall goals. • For examples the healthcare systems of U.S.A, Canada , Saudi Arabia, and other. H.M. BORIE

11. Elements of Healthcare Systems • Inputs ( human resources , material , technology , information , capital , ……. • Outputs ( patient care , acceptable costs , training , other objectives ) . • Process • Feedback • Outcome (improvement in infant mortality rate, life expectancy at birth,…….) H.M. BORIE

12. The Health Care Delivery System • Functions through Complex interaction among: • Government • Health Professionals • Consumers • Third party payers • Employers • Delivery Systems • These groups use competition, standards, a regulation to pursue a balance in their respective health care goals of access, quality, and finance . • There is no single source of governance or health policy…. • It is an amalgamation of many different agendas H.M. BORIE

13. The Canadian Health Care System • The System is based on independent “Provincial Care” • Each Province has its own health insurance plan • All provinces apply the following minimum federal health criteria: • Universal insurance coverage • Comprehensive coverage (inpatient and outpatient hospital) • Portable coverage for residents who move to different province • Publicly operated on none profited basis

14. Canadian Coverage: Universal and comprehensive Access: No financial Barriers Private insurance: Small Payers model: single Cost control: High and Centralized System capacity: High degree of control United States Coverage: Mixed: Medicare and private Access: Financial Barriers Private insurance: Large Payers model: multiple Cost control: Low and fragmented System capacity: Low degree of control Comparison between Canadian and American Health Care system

15. **U.S.A** Total population: 298,213,000 GDP per capita :(Intl $, 2004) 39,901 Life expectancy at birth m / f ( years ) 75.0/80.0 Healthy life expectancy at birth m / f ( years, 2002 ) 67.2/71.3 Child mortality m / f ( per 1000 ) 8/7 Adult mortality m / f ( per 1000 ) 137/81 Total health expenditure per capita ( Intl $, 2003 ) 5,711 Total health expenditure as % of GDP ( 2003 ) 15.2 **WHO REPORT 2006**

16. *Saudi Arabia* Total population : 24,573,000 GDP per capita ( Intl $, 2004 ) 15,307 Life expectancy at birth m / f ( years ) 68.0/74.0 Healthy life expectancy at birth m / f ( years, 2002 ) 59.8/62.9 Child mortality m / f ( per 1000 ) 29/24 Adult mortality m / f ( per 1000 ) 196/120 Total health expenditure per capita ( Intl $, 2003 ) 578 Total health expenditure as % of GDP ( 2003 ) 4.0 *WHO REPORT 2006 * H.M. BORIE

17. EGYPT* • Total population: 74,033,000 • GDP per capita ( Intl $, 2004 ) 4,274 • Life expectancy at birth m / f ( years ) 66.0/70.0 • Healthy life expectancy at birth m / f ( years, 2002 ) 57.8/60.2 • Child mortality m / f ( per 1000 ) 36/36 • Adult mortality m / f ( per 1000 ) 239/158 • Total health expenditure per capita ( Intl $, 2003 ) 235 • Total health expenditure as % of GDP ( 2003 ) 5.8 • WHO REPORT 2006* H.M. BORIE

18. POPULATION (size.distrbution.growth rate.gene pool) HEREDITY NATURAL RESOURCES CUL TURAL SYSTEMS Life Expectancy Internal Impairment Discomfort Satisfaction External Disability ENVIRONMENT somatic HEALTH social Fetal.physical (natural and man made). sociocultural. (economics. education. employment. etc) Satisfaction MEDICAL CARE SERVICES Participation in health Care (Well-being) prevention.cure.care rehabiliation Reserve Interpersonal psychic Behavior Health Behavior Social Behavior HUMAN SATISFACTIONS Ecologic Behavior ECOLOGIC BALANCE LIFF STYLES attitudes. behavior

19. * The force-field and well-being paradigms of health. (from Blum. Henrik K. Expanding health care horizons: From a general systems concept of health to a national health policy. 2d ed., 37. Oakland, CA: Third Party publishing Company. 1983: reprinted by permission.) • * Blum suggests golas for the health system: • - prolonging life and preventing premature death; • - minimizing departures from physiological or function norms by focusing attcntion on prccurors of illness; • - minimizing discomfort (illness): • - minimizing disability (incapacity): • - promoting high-level “wellness” or self-fulfillment: • - promoting high-level satisfaction with the environment; • - extending resistance to ill health and creating reserve capacity: and • - increasing opportunities for consumers to participate in health matters.

21. Education of Managers

22. The University of Chicago established the first master's degree program in 1934. now it is the American College of Healthcare Executive (ACHE). H.M. BORIE

23. About 60 graduate programs were accredited by the Accrediting Commission on Education for a professional Health Services Administration . H.M. BORIE

24. United States master's degree programs have more than 25,000 graduates . H.M. BORIE

25. Educational programs provide a generic education in health services, rather than hospital, management . Some offer specialty preparation in hospital, nursing facility, or ambulatory services management. H.M. BORIE

26. The didactic portion for accredited programs is two academic years; 4 Semesters. Most programs include field experiences of varying lengths. Many require a 1-year residency that allows application of the academic preparation under the guidance of an On-Site preceptor. H.M. BORIE

27. The most common educational preparation for HSO managers is the master degree. H.M. BORIE

28. The basic curriculum in accredited health services management graduate programs covers eight areas: - H.M. BORIE

29. 1Assessment and understanding of health status of populations; determinants of health and illness; and factors influencing the use of health services. H.M. BORIE

30. 2Understanding of the organization, financing and delivery of health services, drawing on the social science disciplines ( economics, law, political science, physiology, sociology, and related disciplines). H.M. BORIE

31. 3 Understanding of, and development of skills in, economic, financial, policy, and quantitative analysis. H.M. BORIE

32. 4 Understanding of the values and ethical issue associated with the practice of health services administration, and the development of skills in ethical analysis. H.M. BORIE

33. 5Understanding of, and development of skills in, positioning organizations favourably in the environment and managing these organizations for continued effectiveness. H.M. BORIE

34. 6 Provision of opportunities for development of leadership potential including stimulating creativity, and interpersonal and communication skill development. H.M. BORIE

35. 7Understanding of, and development of skills in, the management of human, capital, and information resources. H.M. BORIE

36. 8Understanding of, and development of skills in, evaluation methods to assess organisational performance and, in particular; methods to assure the quality of services provided. H.M. BORIE

37. AS with the graduate programs, rapid growth in the number of undergraduate programs preparing health services management personnel occurred its the late 1960s and early 1970s. H.M. BORIE

38. Master programs prepare graduates to become senior-level line or staff managers; baccalaureate programs train middle-level supervisors or department managers. H.M. BORIE

39. Managers in other types of HSOs are unlikely to be licensed. A state regulatory arm is exercised when problems suggest that a profession's self-regulation and self-discipline are ineffective and the state must act to protect the public. H.M. BORIE

40. Licensure, Certification, and Registration of Caregivers • Licensure: a process performed by government that allows someone to engage in an occupation after finding that the applicant has achieved a certain minimum competency . Physicians and dentists are always licensed, for example . • Registration: qualified individuals are listed on an official roster maintain by government or nongovernmental body (registered nurse)

41. CERTIFACTIN • A process by which a nongovernmental agency or association grants recognition to someone who meets its qualification (Nurses-midwives are certified for example). • Physicians • Nonphysician Caregivers : Dentists, Physician Assistant, Pharmacists, Technologists, & other .

42. PROBLEMS & ISSUES OF PERSONNEL • SHORTAGES • MALDISTRIBUTION • IMMIGRATION & FMGs • HEALTHCARE EDUCATION • Diagnostics- Related Groups • CON, UR, PSROs, and PROs

43. POPULATION (size.distrbution.growth rate.gene pool) HEREDITY NATURAL RESOURCES CUL TURAL SYSTEMS Life Expectancy Internal Impairment Discomfort Satisfaction External Disability ENVIRONMENT somatic HEALTH social Fetal.physical (natural and man made). sociocultural. (economics. education. employment. etc) Satisfaction MEDICAL CARE SERVICES Participation in health Care (Well-being) prevention.cure.care rehabiliation Reserve Interpersonal psychic Behavior Health Behavior Social Behavior HUMAN SATISFACTIONS Ecologic Behavior ECOLOGIC BALANCE LIFF STYLES attitudes. behavior

44. * The force-field and well-being paradigms of health. (from Blum. Henrik K. Expanding health care horizons: From a general systems concept of health to a national health policy. 2d ed., 37. Oakland, CA: Third Party publishing Company. 1983: reprinted by permission.) • * Blum suggests golas for the health system: • - prolonging life and preventing premature death; • - minimizing departures from physiological or function norms by focusing attcntion on prccurors of illness; • - minimizing discomfort (illness): • - minimizing disability (incapacity): • - promoting high-level “wellness” or self-fulfillment: • - promoting high-level satisfaction with the environment; • - extending resistance to ill health and creating reserve capacity: and • - increasing opportunities for consumers to participate in health matters.