reading class 3 PALFREY chpt 4 Policy implementation
MUDr. Petr Háva, CSc.
Annotation -
Last update: HAVA (01.10.2007)
The course provides a conceptual and analytical approach to the models of how health care is organized, financed, and delivered. Definitions of health policy, health care systems, and health care services will be analyzed. Several aspects of health care systems and services are explored: the health care system as an expression of economic, political, and social structures; welfare policies and their impact on health care system. Role of World Health Organization (WHO), Organization for Economic Co-operation and Development (OECD), European Observatory on Health Care Systems and Policies will be analyzed. Global free trade agreements and their impact on health care systems and public health will be discussed. The current health care systems in the Czech and Slovak Republic, Austria, England, USA,. Canada, Russian Federation will be analyzed. The debate over national health care system reforms will be presented.
Last update: HAVA (01.10.2007)
Východiskem srovnávacího přístupu jsou konceptuální a analytické modely organizace, financování a poskytování zdravotní péče. Stručně jsou charakterizovány zdravotní politika, systémy zdravotní péče a zdravotnické služby a jejich analýza je provedena v ekonomickém, sociálním a politickém kontextu sociálních států. Pozornost je věnována významným mezinárodním aktérům (WHO, OECD, European Observatory on health Care Systems and Policies, WTO) včetně vlivů globalizace v oblasti obchodu. Srovnávány jsou Česká a Slovenská republika, Rakousko, Velká Británie, USA, Kanada a Ruská Federace včetně jejich aktuálních reformních přístupů.
Účelem kurzu je zvýšit kapacitu studentů ke kritické reflexi zdravotní politiky a jejího kontextu.
Aim of the course -
Last update: PhDr. Věra Tomandlová (07.04.2008)
Increase the analytical capacity and critical thinking of students in the field of health care, health policy and their context.
Last update: PhDr. Věra Tomandlová (07.04.2008)
Účelem kurzu je zvýšit kapacitu studentů ke kritické reflexi zdravotní politiky a jejího kontextu.
Literature -
Last update: HAVA (01.10.2007)
Literature
Required book and texts:
Saltman, R., Figueras, J. (edit) European Health Care Reform. Analysis of Current Strategies. WHO regional Publications, European Series, No 72. WHO, Regional Office Europe, Copenhagen 1997 (chpts 1, 2, 3, 4, 5, 6)
Palfrey, C. Key Concepts in health Care Policy aqnd Planning. An Introductory Text. Macmillan Press, Houndmills 2000 (Chpt 1-5)
Countries
Czech Republic
Highlights on health in Czech Republic (2005) http://www.euro.who.int/Document/E88735.pdf
Rokosová, M., Háva, OP., Schreyogg, J., Busse, R. health care systems in transition: Czech Republic. Copenhagen, WHO regional Office for Europe on behalf of the European Observatory on health Systems and Policies, 2005 http://www.euro.who.int/Document/E86823.pdf
Institute of Health Statistics www.uzis.cz
Slovak Republic
Highlights on Health in Slovakia 2005 http://www.euro.who.int/Document/e88407.pdf
Nemec, J. (2005) Reforms of Health Care Delivery in Slovakia and Measurement of Their Impacts: Quality of Hospital Services and Quality of Financial Management in Hosp
http://www.spa.msu.ru/e-journal/9/91_1.php
Health Policy Institute
http://www.hpi.sk/index.php?lang=en
Austria
Hofmarcher, M.M., Rack, H.M. Austria: Health system review. Health Systems in Transition, 2006; 8(3): 1-247
(Chpt 1: pp 1-11 Introductory overview, Chpt 6: pp 195214 health care reforms; Chpt 7: pp215-224 Conclusions)
http://www.euro.who.int/Document/E89021.pdf
United Kingdom
Highlights on Health in UK (2004): http://www.euro.who.int/document/e88530.pdf
Summary: pp. 32-34
United States of America
Docteur, E., Suppanz, H., Woo, J. (2003) The US Health System: An Assessment and Prospective Directions for reform. Economics Department Working Papers No. 350. OECD, Paris (pp.1-63)
Marchildon, G.P., health Systems in Transition: Canada. Copenhagen, WHO regional Office for Europe on behalf of the European Observatory on health Systems and Policies, 2005 (p 1., overview of health system, Chpt 7: pp 105-118 Principal health care reforms, Chpt 8: pp 119-130 Assessment of the health system, Chpt 9: pp 131-134 Conclusions)
Russia
Tompson, W. (2007) Healthcare Reform in Russia: Problems and Prospects. Economic Department Working Papers No 538. OECD, Paris (http://www.olis.oecd.org/olis/2006doc.nsf/43bb6130e5e86e5fc12569fa005d004c/3eff23b4f299a8f3c125726c004d19be/$FILE/JT03220416.PDF)
Economic survey of the Russian Federation 2006: Reforming healthcare. OECD assessment and recommendations summarise Chapter 5 of the Economic survey of the Russian Federation 2006, published on 27 November 2006. http://www.oecd.org/document/26/0,3343,en_2649_34571_37723098_1_1_1_1,00.html
Last update: HAVA (01.10.2007)
Literatura:
Literatura
Požadované knihy a texty k obecné části (tyto materiály jsou dostupné na webové stránce):
Saltman, R., Figueras, J. (edit) European Health Care Reform. Analysis of Current Strategies. WHO regional Publications, European Series, No 72. WHO, Regional Office Europe, Copenhagen 1997 (chpts 1, 2, 3, 4, 5, 6)
Palfrey, C. Key Concepts in health Care Policy aqnd Planning. An Introductory Text. Macmillan Press, Houndmills 2000 (Chpt 1-5)
Údaje k vybraným zdravotnickým systémům:
Czech Republic
Highlights on health in Czech Republic (2005) http://www.euro.who.int/Document/E88735.pdf
Rokosová, M., Háva, OP., Schreyogg, J., Busse, R. health care systems in transition: Czech Republic. Copenhagen, WHO regional Office for Europe on behalf of the European Observatory on health Systems and Policies, 2005 http://www.euro.who.int/Document/E86823.pdf
Institute of Health Statistics www.uzis.cz
Slovak Republic
Highlights on Health in Slovakia 2005 http://www.euro.who.int/Document/e88407.pdf
Nemec, J. (2005) Reforms of Health Care Delivery in Slovakia and Measurement of Their Impacts: Quality of Hospital Services and Quality of Financial Management in Hosp
http://www.spa.msu.ru/e-journal/9/91_1.php
Health Policy Institute
http://www.hpi.sk/index.php?lang=en
Austria
Hofmarcher, M.M., Rack, H.M. Austria: Health system review. Health Systems in Transition, 2006; 8(3): 1-247
(Chpt 1: pp 1-11 Introductory overview, Chpt 6: pp 195214 health care reforms; Chpt 7: pp215-224 Conclusions)
http://www.euro.who.int/Document/E89021.pdf
United Kingdom
Highlights on Health in UK (2004): http://www.euro.who.int/document/e88530.pdf
Summary: pp. 32-34
United States of America
Docteur, E., Suppanz, H., Woo, J. (2003) The US Health System: An Assessment and Prospective Directions for reform. Economics Department Working Papers No. 350. OECD, Paris (pp.1-63)
Marchildon, G.P., health Systems in Transition: Canada. Copenhagen, WHO regional Office for Europe on behalf of the European Observatory on health Systems and Policies, 2005 (p 1., overview of health system, Chpt 7: pp 105-118 Principal health care reforms, Chpt 8: pp 119-130 Assessment of the health system, Chpt 9: pp 131-134 Conclusions)
Russia
Tompson, W. (2007) Healthcare Reform in Russia: Problems and Prospects. Economic Department Working Papers No 538. OECD, Paris (http://www.olis.oecd.org/olis/2006doc.nsf/43bb6130e5e86e5fc12569fa005d004c/3eff23b4f299a8f3c125726c004d19be/$FILE/JT03220416.PDF)
Economic survey of the Russian Federation 2006: Reforming healthcare. OECD assessment and recommendations summarise Chapter 5 of the Economic survey of the Russian Federation 2006, published on 27 November 2006. http://www.oecd.org/document/26/0,3343,en_2649_34571_37723098_1_1_1_1,00.html
Základní podklady ke kurzu jsou ve formě full textů na www.observatory.dk (European Observatory on Health Care Systems and Policies)
časopisy: Zdravotnictví v ČR (www.zcr.cz), Journal of American Medical Association (český překlad JAMA), British Medical Journal (www.bmj.com), Health Affairs, Bulletin of the WHO (www.who.int); užitečné internetové stránky: www.observatory.dk, www.who.int, www.who.dk, www.oecd.org
Braveman, P., Gruskin, S. Defining equity in health. Theory and methods. J.Epidemiology Community Health 2003; 57:254-258Dying too young. Addressing Premature Mortality and Ill Health Due to Non-Communicable Diseases and Injuries in the Russian Federation. Europe and Central Asia Region, Human Development Department, Russia Country Management Unit, The World Bank 2005Figueras, J., McKee, M., Cain, J., Lessof, S. Health systems in transition: learning from experience. World Health Organization, 2004
Gladkij, I a kol. Management ve zdravotnictví. Computer Press, Brno 2003
Gunning-Schepers, L.J., van HERTEN, L.M. Targets in health policy. European Journal of Public Health 2000; 10(4), Supplementum, 2-6 (český překlad tohoto článku je k dispozici na www.izpe.cz)
Health 21 ? Health for All in the 21th Century. Copenhagen: World Health Organization Regional Office for Europe, 1998
Mossialos, E., Dixon, A., Figueras, J., Kurtin, J. Funding health care: options for Europe. European Observatory on Health Care Systems Series. Open University Press, Buckingham 2002.
Mossialos, E., Le Grand, J. (ed.) Health Care and Cost Containment in the European Union. Aldershot: Ashgate, 2002. ISBN 1-84014-403-3
Mossialos, Elias, McKee, Martin. EU Law and the Social Character of Health Care. Travail & Société - Work & Society, Vol. 38, PIE-Peter Lang, 2002,
OECD(2000) A System of Health Accounts for International Data. Paris 2000.
OECD (2002) Measuring Up. Improving Health System Performance in OECD Countries,
OECD (2004a) Towards High-Performing Health systems. The OECD Health Project. OECD, Paris 2004
OECD (2004b) Private Health Insurance in OECD Countries. The Benefits and Costs for Individuals and Health Systems. OECD, Paris 2004
OECD (2004c) Private Health Insurance in OECD Countries. The Benefits and Costs for Individuals and Health Systems. OECD, Paris 2004
Roberts, M.J., Hsiao, W., Berman, P., Reich, M.R. Getting Health reform Right. A Quide to Improving Performance and Equity. Oxford University Press, Oxford 2004
Saltman, R. B., Busse, R., Mossialos, E. Entrepreneurial behaviour in pharmaceutical markets and the effects of regulation. Buckingham: Open University Press, 2002a.
Saltman, R.B., Busse, R., Mossialos, E. regulating entrepreneurial behaviour in European health care systems. European Obervatory on Health Care Systems Series. Open University Press, Buckingham 2002b
Saltman, R. B., Figueras, J., Sakellarides, C. Critical challenges for health care reform in Europe. Buckingham: Oxford University Press, 1998
Saltman, R. B., Figueras, J. European health care reform. Analysis of current strategies. Copenhagen: World Health Organization, 1997
Sox, H.C. The Future of Primary Care. Annals of Internal Medicine 2003, 138(3): 230-231
Šimek, J., Špalek, V., Křížová, E., Janečková, H. Etické aspekty transformací zdravotnických systémů v rozvinutých státech světa. Univerzita Karlova v Praze, Karolinum 2002
Wagstaf, A. Poverty and health sector inequalities. Bulletin of the WHO 2002, 80(2): 97-105
Whitehead, M. The Concepts and Principles of Equity and Health. Copenhagen: WHO, dostupné z http://www.who.dk/Document/PAE/conceptsrpd414.pdf
Wilkinson, R., Marmot, M. (eds.) Social Determinants of Health: The Solid facts. Copenhagen: WHO, 2003.
World Health Report 2000. Health Systems: Improving Performance. WHO, Geneva 2000
Ziglio, E. at. al. Health Systems Confront Powerty. Copenhagen: WHO, 2003.
Ziglio, E. at. al. Investment for Health: a discussion of the role of economics and social determinants. Copenhagen: WHO, 2002.
Ziglio, E. at. al. Investment for Health: a discussion of the role of economics and social determinants. Copenhagen: WHO, 2002
Syllabus -
Last update: HAVA (01.10.2007)
Purpose: Increase the analytical capacity and critical thinking of students in the field of health care, health policy and their context.
Objectives:
1.Apply a social ecological framework and social medicine approach analyzing health care systems and recognize the relationship between the other disciplines studied in the MPH and related fields.
2.Understand the dynamic of the actors involved in the health care systems (federal, state, and local governments, profit and non-profit organizations, entrepreneurs, patients/citizens, advocacy groups, charity groups).
3.Understand the most important health care system problems and proposals for solutions.
4.Reinforce social responsibility and understand core functions and essential public health services.
5.Improve the capacity to work sensitively and appropriately in culturally, racially, economically, socially, and linguistically diverse environments.
Methods: Each class meets for 80 minutes, once a week (Thursday 12:30-13:50). Students will be expected to read recommended readings before the class and come prepared to discuss. In each class, students, individually or in groups, will carry out the responsibility to introduce the readings assigned in the previous class.
The course starts with the knowledge and opinions of the students about health care systems and health care services through their personal, family, professional, and/or community experiences. Lectures, presentations, discussions, readings, and case discussions help to develop a more critical thinking of the health care system. The instructor provides the basic literature, but the students will have an active role in suggesting new reading materials. The students will receive assistance from instructor for bibliographical research. New reading materials could be added during the course.
Course Requirements and Grading:
1.Course participation (30% of grade). This includes attendance, active participation in class discussions.
2.3-5 page final paper based on topics selected by the student (35%). Due two days before oral exam..
3.Oral exam (35%) in January of February. Exact days and times will be specified during the last two lectures.
The instructor will provide the guidelines during the class and office hours.
Office hours: Thoursday 14:30-16:00, room No 3007, Jinonice, Building B, third floor. Instructors mail address is: petr.hava@gmail.com
Web site. Materials for this course are also available in the course?s web site: htttp://samba.fsv.cuni.cz/~hava [Intenational comparison of health care systems and policies]. You can use this site without passwords. Please, open the syllabus and print it out for future reference.
Course outline and introductory readings:
1. Introduction and conceptual framework. Health care system model. Health and its determinants. Pressure for reform, reform themes.
2.Health care organization, delivery. Health promotion, Public health, Outpatient, inpatient, Primary care, hospitals, Long term care
3.Health care policy (concepts, models),stake-holders in health care systems, international actors: WHO, Eur. Observatory on Health Care Systems and Policies, OECD, World Trade Organization, World Bank
4.Financing and payment.Copayment, commercionalization of health care, markets and health care, ethical dimensions
5.Czech Republic
Transformation and reforms after 1990. Pluralistic model of public non-government health insurance funds.
6.Slovak Republic. Marketization of the system
7.Austria (federal system)
Social health insurance tradition, pluralistic model of health insurance funds
8.UK (National Health System)
9.USA (private-public mix of payers, federal system)
10.Canada (public single payer)
11.Russian Federation (federal system)
12.Public health in EU
13.The way forward, overview of current debates about alternatives of future development, ethical dilemmas
Investment in health, globalization,, welfare state
Last update: HAVA (01.10.2007)
Cíle:
1.Aplikace sociálního a ekologického rámce a dalších disciplín při analýze systémů zdravotní péče
2.Porozumět jednání zúčastněných aktérů zdravotnických systémů na federální, státní a lokální úrovni, podnikatelům, pacientům, občanům).
3.Porozumět důležitým problémům zdravotnických systémů a návrhům na jejich řešení.
4.Zdůraznit význam sociální odpovědnosti a základních funkcí veřejného zdraví.
5.Citlivě a adekvátně vnímat kulturní,ekonomické, sociální, lingvistické a etnické rozdíly.
Realizace: Kurz probíhá pravidelně každý týden v rozsahu 80 minut, ve čtvrtek od 12,30 do 13,50 hod. Předpokládá se, že studenti se studenti před každou hodinou seznámí s doporučenými úvodními texty a budou tak připraveni pro diskusi tématu.
Požadavky a podíl hodnocených aktivit studentů:
1.Aktivní účast v jednotlivých hodinách (30%).
2.Na konci kurzu odevzdají studenti 3-5 stránkovou esej na samostatně vybrané téma, jehož podkladem je článek z odborného zahraničního časopisu nebo kapitola z knihy (35%). Termín odevzdání textu je dva dny před ústní zkouškou.
3.Ústní zkouška (35%), jejímž podkladem je okruh otázek, související s probranými tématy. Termíny pro ústní zkoušky budou dohodnuty se studenty ve dvou posledních týdnech výuky.
Konzultační hodiny: čtvrtek 14,30-16,00, místnost č. 3007, Jinonice, budova B, třetí podlaží. Mailová adresa přednášejícího: petr.hava@gmail.com; telefon na katedru veřejné a sociální politiky 251080455 (451).
Webové stránky. Materiály ke kurzu, včetně podrobnějšího sylabu, jsou přístupné bez hesla na adrese: htttp://samba.fsv.cuni.cz/~hava [International comparison of health care systems and policies].
Orientační struktura kurzu:
1.Úvod, základní konceptuální rámce. Model zdravotnického systému, Zdraví a jeho determinanty. Problémy zdravotnických systémů, jež jsou příčinami úvah o reformách.
2.Organizace a poskytování zdravotnických služeb. Ambulantní a lůžkové zdravotnické služby, koncept primární péče, role nemocnic a význam dlouhodobé lůžkové péče.
3.Zdravotní politika (koncepty, modely), aktéři zdravotnických systémů. WHO, Eur. Observatory on Health Care Systems and Policies, OECD, World Trade Organization, World Bank.
4.Financování a úhrady zdravotnických služeb. Spoluplatby, komercionalizace zdravotní péče, trh a péče o zdraví, etické dimenze.
5. Česká republika
Transformace a reformy po roce 1990. Pluralistický model nestátního veřejného zdravotního pojištění. Hnilicová
6.Slovensko
Marketizační reforma.
7.Rakousko. Dlouhá tradice sociálního zdravotního pojištění, pluralistický model pojištění.
8.Velká Británie (National Health System)
9. USA (mix soukromých a veřejných pojišťoven, vztahy federace a jednotlivých států)
10.Kanada (financování z veřejných zdrojů)
11.Ruská federace.
12.Veřejné zdraví v EU
13.Další možnosti vývoje, přehled současných diskusí o alternativách vývoje, etická dilemata, investice do zdraví, vlivy globalizačních procesů v kontextu sociálních států.
