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MODULE
IN
ADVANCED HEALTH CARE ECONOMICS
Identify major current trends that affect the delivery of health care.
Understand the changing role of nurses and other allied health care providers
Health Care Economics course is conducted using the modular approach. It has been designed to
accommodate the needs of the working nurse. There will be no class meetings for those Learning
Centers outside of Tuguegarao. The module is more of a self-paced program of independent study.
You have to research in order to answer each module and to have proper time management.
You may use available resources in the SPUP Library or in the area where you are, surf the net or
any other materials/references you can take hold of on Health Economics Scientific
Publications, costs and quality, RA 78759 (National Health Insurance Program) which created
Philippine Health Insurance Corporation. You may stay in the library during the scheduled class days
so you can finish your requirements.
You will be evaluated depending on how well you complete the modules and part assignments
outlined. The following table shows the point and percentage value of each of the instructor-
evaluated activities for the modules.
PART I
Module A to B Module Completion 100 50%
PART II
Journal Article summary
Critique 2Readings with
complete annotations/ 50 25%
bibliography
PART III
Insights 50 25%
Essay
The passing grade based on the accumulated point scores 85% and above.
MODULE A Introduce the students on health economics by highlighting the following:
Insights/perspective
Factors affecting health care costs and implications of these factors on economics
and quality care
Objective: Identify major trends likely to affect the delivery of health care and the role
of health care providers.
OVERVIEW:
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.
The following terms are important in this module. You should be able to provide definitions
before you start:
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)
Health Outcome- net impact of health care on health status
Two activities can be measured: Cost of medical care and cost of illness-
QUESTION: The economy as a whole is measured by the Gross National Product. From _____to ______,
what percentage of the GNP was allocated to Health? What is Gross National Product?
SOURCE:_______________________________________________
Date as of:_______________________
It is clear that national health expenditures rise with income per capita. Do health outcomes
improve in the same way? Explain
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
QUESTION: In terms of health care expenditure, how much had government and the private sector
spent for health care. From the public sector,
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.
QUESTION:
Explain /discuss why these 11 factors identified have contributed to the high cost of health care.
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.
CONCEPT of COST:
Cost determination
Activity forecasting
Functional Cost - Center Budgeting
Performance reporting on a product level
Performance reporting on a functional level
Define and explain the 5 functions of cost management. You may use any journal on Health
Economics, or managing health care costs, quality and technology by Mychelle Mowry et al.
1._______________________________________________________________________________
_______________________________________________________________________________
2._______________________________________________________________________________
_______________________________________________________________________________
3._____________________________________________________________________________
_____________________________________________________________________________
4._____________________________________________________________________________
_____________________________________________________________________________
5._____________________________________________________________________________
_____________________________________________________________________________
QUESTION:
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.
What are the diagnostic problems and how they are resolved?
_______________________________________________________________________
_______________________________________________________________________
Introduction:
Hospitals are complex institutions and different parts of the hospital actually produce different products.
The average is made up of some basic services for routine admissions, along with some specialized units
as heart transplant, oncology and respiratory intensive care.
Hospitals exist to allow a large number of doctors to share expensive capital, equipment and cooperate
in the care of many patients. Since many of these costs are fixed, hospitals should show economies of
scale (average cost per patient per day falling as more patients are treated). The need to accommodate
random fluctuatios in the number of admissions and to preserve some buffer of empty beds for
emergencies create economies of scale.
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
Most care decisions are made by the doctors hence, hospitals compete for doctors.
If ability to decide on hospitalization is taken out of the doctors, compete for contracts and appeal to
payors lower prices
Note: Hospitals must compete for the party that has the power to make the revenues come to them,
not the patient
QUESTION:
For foreign students they may discuss their own health insurance program available in their country.
QUESTION:
Purpose
Coverage
Nature
National Health Insurance Program Fund
(where, whom and percentage how the fund is appropriated)
QUESTION: Identify 10 activities of the program (QAP) in each institution:
Reference: Rule XVII, section 92 of the Revised Rules and Regulations implementing the National Health
Insurance Act of 1995 (R.A. 7875). Activities of QAP specific for health care providers.
Nursing often has taken the lead in patient care quality assurances by investigating the quality of service
delivered by practitioners.
A review mechanism should replace group accountability and care activities maybe tracked for
individual patients and compared against a set of clearly defined standards. Such a system provided an
excellent framework for quality assurance systems.
How can nursing establish an environment and structure that facilitates QA mechanism?
1. 6.
2. 7.
3. 8.
4. 9
5. 10.
Summary:
Health care providers should identify the inefficiencies that have developed in the industry,
largely because of the manner in which hospitals have been financed. Prospective Payment (PhilHealth)
is designed to encourage hospital administrators to manage the process in the most cost-effective
method possible while simultaneously assuring quality health care.
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.
Critique at least 2 latest trends/ issues related to Health Economics. Give a summary of the article
then critique each. Please do proper annotation.
With the current economic situation that nurses are facing in terms of implementation of
the Philippine Health Care Goals, the Department of Health has to maximize the active
involvement of nurses to attain the National Development Health Goals.
Considering the knowledge that you have gained in Health Care Economics answer the
following questions:
1. How can you improve the current economic situation of professional nurses?
2. How can you further enhance the development of the nursing profession so that nurses
can also contribute to the countrys income?
3. Philippines is part of the 10 countries in the ASEAN integration, as a professional nurse,
what is the impact of this in your current job and in the Philippine economy?
Note: This module was based on the Advanced Health Care Economics Module developed by Dr. Grace Valderrama.
Saint Paul University Philippines
Tuguegarao City, 3500 Cagayan North
EN200:
Entrepreneurship in Nursing
This will be you first reflective journal, please answer the following questions to ponder.
1. What is the best contribution of entrepreneurship in nursing? Why?
2. In discussing the different development and growth theories, what do you think is the
best?
Explain.
3. How can economic nationalism help our economy?
4. What is the role of government in economic development?
6. Explain one program of the government for the development of micro or small business
email to geh_jordan@yahoo.com