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GRADUATE SCHOOL
MODULE
IN
ADVANCED HEALTH CARE ECONOMICS with
ENTREPRENEURSHIP IN NURSING
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COURSE TITLE:
COURSE LEARNING OUTCOMES: At the end of the course the student will have been able to:
1. Discuss major trends that affect the delivery of health care.
2. Discuss the changing role of nurses and other allied health care providers
within health services.
3. Appreciate the significance of the changing role of management and the
competencies required to function in the managerial role to optimize utilization of
resources.
4. analytically evaluate business opportunities through SWOT analysis and Market
research
5. Develop a business plan (in health or nursing).
6. Show evidence of research skills in accomplishing course requirements.
MODE OF STUDY:
I.
II.
DISCUSSION
Students can email the professor for questions, clarifications as needed.
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Advanced Health Care Economics with Entrepreneurship in Nursing course is conducted using the
modular approach. It has been designed to accommodate the needs of the working nurse. The module
requires a lot of independent reading, study and writing. You have to research in order to answer each
module and to have proper time management. Answers to the assignments must be submitted a month
after receipt of the module.
Placement
PART I
Module A to B
PART II Module C
Type of
Assignment
Points
Percentage of
Module Grade
Module Completion
100
50%
Completion of Module C
Submission of Business
Plan
100
50%
The minimum passing grade based on the accumulated point scores 85%.
Reminder: Scholarly papers and project based on the stated assignments in Parts I and II, must
be submitted to the professor both in print and soft copy. Thank you.
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MODULE PROPER:
MODULE A Introduction to health economics by highlighting the following:
1. Economic history, population growth and health care
2. Factors affecting health care costs and implications of these factors on
economics and quality care
3. Insights/perspective
Objective: Identify major trends likely to affect the delivery of health care and the role
of health care providers.
A. OVERVIEW:
Health Care Economics as a course discusses fundamental concepts/principles/theories of cost
management and its application to the Health Care Industry.
Economics as a science
Study of men at work against scarcity
A battle of matching resources against vast needs and wants (scarcity)
Economics is the social science concerned with production and distribution of goods and
services produced by forms employing workers and other scarce factors of production of an
economy.
Mans Needs and Wants
Basic needs (food, shelter, clothing)
Needs essential to decent and comfortable living (beyond basic needs)
Luxury goods
Created wants (created by advertising and marketing)
Varying needs and wants (child, children versus adults)
Public wants- (parks, malls, internet cafes, beach resorts, etc.)
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Health Economics
Costs
Created wants versus Public wants
Managed care
Capitation
Preferred Payment Organization
The following terms are important in this module. You should be able to provide definitions
before you start:
1. The chapter begins by asserting that four preconditions are necessary for the
establishment of modern medical care: effective medical technology, sufficient
wealth, low risk of death, and insurance financing.
QUESTION: Explain why each of the following is necessary?
interrelated?
2.
3.
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Health Status is the actual health status of an individual or a population. Health status can be
Measured by:
Morbidity- number of individuals who are ill
Mortality- number of individuals in a population who passed from one
State (alive) to the other (dead)
INSTRUCTION:
Before proceeding further, get the most recent data from the Department of Health
in terms of Morbidity and Mortality for the country where you live.
For foreign students you can get your data from your own country.
Two activities can be measured: Cost of medical care and cost of illnessQUESTION : The economy as a whole is measured by the Gross National Product. From 2005 to 2012,
what percentage of the GNP was allocated to Health? What is Gross National Product?
YEAR
GROSS NATIONAL
INCOME per capita
GROSS NATIONAL
PRODUCT
at current price
BUDGET
FOR HEALTH
PERCENTAGE
FOR HEALTH
2007
2008
2009
2010
2011
2012
2013
SOURCE:_______________________________________________
Date as of:_______________________
QUESTION : It is clear that national health expenditures rise with income per capita. Do health
outcomes improve in the same way? Explain
The price of health care is determined by the cost of accessing and utilizing health care. It is important to
know that seeking health care includes costs other than what people pay health providers for health
services rendered or goods assured. (Policarpio, 2006)
So, there are factors that can be considered that can cause high cost of health care.
Factors that cause high cost of health care:
1. Increased use of health agencies
2. Inflation
3. Population increase
4. Demography
5. Focus on illness care
6. Cost reimbursement
7. Fee for service reimbursement
8. Technology
9. Indigent care
10. Malpractice (House Bill 4955 or whichever is present in the country you are analysing)
11. Health pattern changes ( Impact on HIV-AIDS, SARS, DENGUE, etc.)
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Discuss why and how these 11 factors identified have contributed to the high cost of health care.
------END of MODULE A-------
QUESTION 4:
MODULE B:
In the previous module, you learned the economic history, population growth and
health care including the factors that affect the cost of health care. This module focuses
on the discussion and economic concepts in cost management and management of
hospital cost and how quality care is affected by these costs.
Objective:
Discuss the changing role of management and the competencies required to function in
the managerial role as well as to optimize utilization of resources.
You should be able to define these terms before you startStandard cost profile
Patient care classification
Quality indicators
Cost determination
Cost center
Revenue center
A. CONCEPT of COST:
Costs are expenses or assets having utility for future periods
1. Cost information in relation to time frame
2. Costs that change in relation to volume or time
3. Cost data utilized for product pricing
4. Costs related to strategic and operational planning and control
B. WHAT IS COST MANAGEMENT?
It is an ongoing process of ___________ ______ and __________________ to meet
strategic directions of the organization. Its uses are product pricing, inventory valuation
and income determination as well as product planning and control.
There are 5 functions of cost management systems:
a.
b.
c.
d.
e.
Cost determination
Activity forecasting
Functional Cost - Center Budgeting
Performance reporting on a product level
Performance reporting on a functional level
QUESTION 1. Explain the 5 functions of cost management. You may use any journal on Health
Economics, on managing health care costs, quality and technology.
QUESTION 2:
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Select a unit of your hospital (e.g. ICU, NICU, DR, OR, Ward, etc.) and answer the
following questions: In case of those who are working in Health Centers you may get
your own workplace and the same with those in the academe- the Skills Laboratory.
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Diseconomies of Scale arise from the difficulties of coordinating and managing a larger
institution.
If more than 500 bed hospital- becomes costly, patients have more complaints
About getting lost in the system and being part of a factory rather than a caring
institution.
Learning Activity:
Read on the following:
1.
2.
3.
4.
5.
6.
7.
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Note: Hospitals must compete for the party that has the power to make the revenues come to them,
not the patient
1. Most care decisions are made by the doctors hence, hospitals compete for doctors.
2. If ability to decide on hospitalization is taken out of the doctors, compete for contracts and
appeal to payors lower prices
QUESTION:
Discuss how the hospitals compete in the following instances:
1. Competing for Patients
_________________________________________________________________________
_________________________________________________________________________
2. Competing for Doctors
_________________________________________________________________________
_________________________________________________________________________
3. Competing for Contracts
_________________________________________________________________________
_________________________________________________________________________
E. NATIONAL HEALTH INSURANCE PROGRAM Republic Act 7875
For foreign students they may discuss their own health insurance program available in their
country.
QUESTION:
A.
1.
2.
3.
4.
Purpose
Coverage
Nature
National Health Insurance Program Fund
(where, whom and percentage how the fund is appropriated)
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a.
b.
c.
d.
e.
f.
g.
h.
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1. Several guiding principles were adopted in the pursuit of NHIP. Explain each one:
i.
j.
Cost Containment
Maximum community participation
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How can nursing establish an environment and structure that facilitates QA mechanism?
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Nurses have a significant impact on quality assurance programs. Nurses are the only providers
who directly care for the patient 24 hours a day from admission through discharge. Therefore, they are
in a position to identify inefficiencies, redundancies, and omissions. Nurses must develop a formal
review mechanism that will trace the care of specific patients by specific nurses.
NURSE ENTREPRENEUR
Nurse Entrepreneurs use their nursing education and business background to start ventures within the
healthcare industryestablishing, promoting and running their own companies. Some develop medical
devices, computerized systems, or home health products. To set out on your own as a Nurse
Entrepreneur, some key skills to have include: creativity, business savvy, ability to find funding and
identify a niche market, as well as a consistent customer base.
You can create a business that could provide patient care, nursing education, home health or
consulting
You can seek out business opportunities and funding
Your experience in healthcare and business skills can be used to build a relevant business.
References:
(Indicate here the various sources/references you used to study Modulea A, B, C. Please use APA
format.)
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B. Journals
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A. Books
C. Web Sources
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Note: This module was based partly on the Advanced Health Care Economics Module developed by Dr. Grace Valderrama.