Healthcare Management

Alan Gillies is Professor of Healthcare Management at the International University of Applied Sciences in Germany. He also holds the titles of Honorary Professor at UCLAN in Preston in the UK and Doctor Honoris Causa at the Iuliu Hatieganu University of Medicine and Pharmacy in Cluj-Napoca, Romania.

• List of abbreviations and acronyms xii Foreword xvi SECTION A The current state of health and healthcare 1 1 The context 3 1.1 About this book 3 1.2 The state of global health 3 1.3 Population as a driver of health 9 References 14 2 An analysis of global health and healthcare 15 2.1 Strengths of global health and healthcare 15 2.2 Weaknesses in global health and healthcare 18 2.3 Opportunities in global health and healthcare 22 2.4 Threats to global health and healthcare 25 2.5 National case study: strengths, weaknesses, opportunities, and threats in the Indian healthcare system 27 References 31 3 The relationship between health and healthcare 33 3.1 Factors impacting on health 33 3.2 Prevention or cure? 36 3.3 Acute episodes versus long-term conditions 39 3.4 Views of healthcare as a system 43 References 49 4 The impact of finance on health 52 4.1 The link between the income of countries and their health outcomes 52 4.2 The proportion of national wealth spent by countries on their healthcare systems 54 4.3 Health outcome measures 58 4.4 The impact of poverty on the broader determinants of health 62 References 68 5 COVID-19 The impact of a once-in-a-century event 70 5.1 The development of the pandemic 70 5.2 National measures to control the pandemic 73 5.3 Developing a vaccine to combat the vaccine 77 5.4 Aftermath of the pandemic 79 References 82 SECTION B Healthcare policy 85 6 Policymaking and health policymaking 87 6.1 Why is policymaking complex? 87 6.2 The policymaking process 89 6.3 Health policymaking 92 6.4 Who are the stakeholders in health policy? 96 6.5 The role of the private sector in making health policy 100 References 103 7 Evidence in policymaking 105 7.1 Evidence-based policymaking 105 7.2 Sources of evidence 108 7.3 Paradigms in policy research 117 7.4 Health policy analysis 122 7.5 Evidence in a complex world 124 References 129 8 Public health policy 132 8.1 The role of public health 132 8.2 Public health policymaking 135 8.3 Public health policy implementation 140 8.4 The relationship between public health and healthcare 146 References 149 9 Global health policy 152 9.1 Globalisation 152 9.2 World Health Organisation and other governmental health agencies 155 9.3 Private philanthropy in global health 163 9.4 Other governmental global agencies impacting on global health 165 9.5 Sustainable Development Goals (SDG) 168 References 170 SECTION C Healthcare financing 173 10 Health financing systems 175 10.1 Health financing functions 175 10.2 Revenue raising 179 10.3 Risk pooling 182 10.4 Resource allocation 185 10.5 Service provision 186 10.6 Public-private partnerships 189 References 191 11 Revenue collection 193 11.1 Taxes 193 11.2 Social insurance contributions 198 11.3 Private insurance contributions 201 11.4 Out-of-pocket payments 206 Note 209 References 209 12 Models of payment to providers 211 12.1 Provider payment models (PPMs) 211 12.2 Fee-for-service as a provider payment model 211 12.3 Capitation as a Provider Payment Model 214 12.4 Global budget as a Provider Payment Model 216 12.5 Pay-for-performance as a Provider Payment Model 217 12.6 Diagnosis-Related Groups (DRGs) as a Provider Payment Model 219 12.7 The role of deductibles, coinsurance, and co-payments in Provider Payment Models 221 References 223 13 Efficient government health spending 225 13.1 Government health expenditure 225 13.2 Fiscal space for health 229 13.3 Improving public sector management 232 13.4 Decentralising healthcare governance 235 References 238 SECTION D The healthcare industry 241 14 Healthcare as an industry 243 14.1 The healthcare industry 243 14.2 The major sectors in the healthcare industry 244 14.3 The ethics of healthcare as a market 249 References 261 15 Hospitals and their management 264 15.1 What hospitals do 264 15.2 Strategic management in hospitals 269 15.3 Service management in hospitals 278 15.4 Financial management in hospitals 281 15.5 Customer management in hospitals 285 References 290 16 Primary healthcare provision 291 16.1 Primary healthcare 291 16.2 Community and long-term care 299 16.3 The relationship between primary healthcare and public health 301 16.4 The business of primary care 304 References 307 17 Supporting industries 310 17.1 Pharmaceutical manufacturing 310 17.2 Medical products and devices 317 17.3 The digital health industry 320 17.4 Global health insurance market 323 17.5 Retail pharmacies 324 17.6 The role of laboratories 327 References 331 SECTION E Management and leadership 333 18 Managing healthcare services and products in global markets 335 18.1 Risk management and product safety 335 18.2 Health product procurement 338 18.3 Competition parameters (quality, delivery, cost, flexibility) 340 18.4 Workforce planning 344 References 348 19 Leadership in healthcare 350 19.1 Styles of leadership 350 19.2 Transactional vs. transformational leadership 352 19.3 Models of transformational leadership 355 19.4 Public leadership 358 19.5 Levels of leadership and governance 360 References 363 20 Risk management in healthcare 365 20.1 Risk management 365 20.2 How the aviation industry has influenced healthcare 368 20.3 A no-blame culture 371 20.4 Patient safety checklists 374 20.5 Critical Incident Reporting Systems 376 References 379 21 Quality assurance in healthcare 381 21.1 What is quality? 381 21.2 Measuring quality 384 21.3 Auditing 385 21.4 Certification and accreditation 388 21.5 International healthcare standards 391 References 396 SECTION F Information and innovation 397 22 Using information to improve clinical care 399 22.1 Record keeping 399 22.2 The role of structured terminologies 402 22.3 Clinical decision support 406 22.4 Patient communication and education 409 References 412 23 Using information to improve the management of hospitals 414 23.1 Hospital management information systems 414 23.2 Big data and data analytics 422 References 428 24 Innovative technologies for healthcare 429 24.1 Telemedicine 429 24.2 Technology-enhanced medical education 433 24.3 Personalised Medicine 437 24.4 Artificial Intelligence (AI) in Healthcare 441 References 445 Glossary of Terms 449 Index 458