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Health Economics

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discussion on Health Economics and Health Care in our country and abroad, and what resources are given by the private sectors and with the very scarce help from the DOH, national and local government, …

discussion on Health Economics and Health Care in our country and abroad, and what resources are given by the private sectors and with the very scarce help from the DOH, national and local government, and from the support given by WHO.

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    • 1. Dr. Ronald Sanchez – Magbitang
      • EDUCATIONAL ATTAINMENT
      • NEHS
      • UST – B.S. Biology (Pre-Med)
      • SLU – Doctor of Medicine (“Meritus”)
      • TRAININGS/SEMINARS/CONVENTIONS
      • Dr. PJGMRMC – Internal Medicine
      • Children's Medical Center – Hematology
      • RITM – 1 st In-Country Training in HIV AIDS
      • Philippine College of Physicians’ Symposium and Conventions
      • Philippine Hospital Associations’ Symposium and Conventions
      • PRESENT POSITION
      • Chief of Hospital
      • Gov. Eduardo L. Joson Memorial Hospital
      • Daan Sarile, Cabanatuan City
    • 2.
      • ... was born on the 28th of July, year nineteen hundred and sixty-six, 10am at the Galang's Maternity Clinic in Batangas St., Santa Cruz, Manila, Philippines. He has a twin sister, Ruby, and they are the youngest among the four siblings. Dr. Magbitang is from Brgy. Bonifacio, San Leonardo, Nueva Ecija, Philippines, where presently he is living with his wonderful and loving family. He had his primary education from San Leonardo Central School where he graduated with honor. Then, had his secondary education from Nueva Ecija High School at Cabanatuan City. Thereafter, finished his Bachelor in Science, Biology from the University of Santo Tomas as preparatory course and subsequently obtained his Doctor of Medicine from the Saint Louis University in Baguio City and gaduated "Meritus". Subsequently, passed the Medical Board Examination on the following year. He had his Residency Training in the Department of Internal Medicine from Dr. Paulino J. Garcia Memorial and Research Center in Cabanatuan City, where he was the Chief Resident for the last 2 years of his training. And, became an Associate Fellow of The Philippine College of Physicians and member of the Philippine Association of Medical Specialists. He had numerous positions in different prestigious medical and non-medical, and NGO's local and national associations and societies. Presently, Dr. Magbitang, is with the Gov. Eduardo L. Joson Memorial Hospital at Daan Sarile, Cabanatuan City, Philippines. He was previously the Medical Section Head and the Chief of Clinics, but has proven himself, and became the Chief of Hospital.
      Dr. Ronald S. Magbitang Chief of Hospital Eduardo L. Joson Memorial Hospital
    • 3. ?
    • 4. HEALTH
    • 5. ECONOMICS Economy
    • 6.  
    • 7.
      • The way a health system is financed and organized is a key determinant of population health and well-being
      • Available funds are still insufficient to ensure equitable access to basic and essential health services
      • In addition, health financing in many settings relies heavily on out-of-pocket payments made directly by patients to providers
      • Lack of ability to pay prevents some people from seeking or continuing care, while some of those who do seek care incur catastrophic financial burdens, and some are pushed into poverty as a result
    • 8.
      • In higher-income countries people are generally less exposed to the financial risks associated with ill health because of greater access to risk pooling arrangements developed through tax-based systems, various types of health insurance, or a mix of tax and insurance
      • Increasingly, government and public attention is focused on reducing waiting times and increasing the quality of care and amenities, while at the same time restraining the rate of increase of overall health costs
    • 9.
      • The way the health system is financed has a direct influence on these factors as well, not just through the availability of funds but also in the way that service delivery is organized and providers are paid
      • Questions of quality of care and rising health costs are also of vital interest to people in low and middle-income countries, but they are often dominated by the overall shortage of funds in those settings
    • 10.
      • Like all aspects of health system strengthening, changes in health financing must be tailored to the history, institutions and traditions of each country.
      • However, six important principles can be used to guide country responses:
        • 1. raising additional funds where health needs are high and revenues insufficient;
        • 2. reducing reliance on out of pocket payments where they are high, by moving towards pre-payment systems;
        • 3. taking additional steps to improve social protection by ensuring the poor and other vulnerable groups have access to needed services, personal and non personal;
    • 11.
        • 4. improving efficiency of resource use by focusing on the appropriate mix of activities to fund and inputs to purchase, provider payment methods and other incentives for efficient service use, and financial, contractual and other relationships with the non-government sector;
        • 5. promoting transparency and accountability in health financing systems;
        • 6. improving the generation and use of information on the health financing system and using it to modify policy where necessary.
      … Six important principles can be used to guide country responses:
    • 12. WHO Health System Financing (Roadmap) The objective of this document is to provide an overview of these tools and guidelines and how they can contribute to the different aspects of health systems strengthening, using the six guiding principles mentioned above as the building blocks First using a diagram linking the different tools to these building blocks or objectives of the health financing system, followed by a brief description of each of these tools Finally, a list of other relevant WHO resources that can contribute to shaping this process and building capacity in this area
    • 13.
      • Estimate the financial costs of scaling up a package of interventions over the medium term
      • Planning and budgeting for health system strengthening; can be used alone or to complement the existing disease specific costing tools to take into account the health systems costs necessary for executing the proposed disease specific interventions
      • Monitor trends in health spending for all sectors - public, private and external. Helps to tracks where the money comes from, how it is pooled and how it is spent for different health care activities
      • Monitor the level and distribution of household financial burden and poverty impact due to out-of-pocket health payments; identify households vulnerable to catastrophic health expenditure
    • 14.
      • Explores health insurance policy options, ensuring financial viability and illustrating equity implications
      • To analyze performance of a health financing system and its respective health financing schemes by assessing key design issues and implementation, identify bottlenecks in the way institutions and organizations function and help in finding institutional and organizational alternatives and solutions to improve health systems performance
      • To inform priority-setting and resource allocation in the health sector via the generation of intervention cost-effectiveness estimates for all leading contributors to disease burden, both at regional and country level
    • 15.  
    • 16.  
    • 17. HEALTH ECONOMICS Health economics – is a branch of economics concerned with issues related to scarcity in the allocation of health and health care. From Wikipedia, the free encyclopedia
    • 18. Health Economics
      • The scope of health economics is neatly encapsulated and dividing the discipline into eight distinct topics:
        • what influences health? (other than health care)
        • what is health and what is its value
        • the demand for health care
        • the supply of health care
        • micro-economic evaluation at treatment level
        • market equilibrium
        • evaluation at whole system level
        • planning, budgeting and monitoring mechanisms
      Alan William’s “plumbing diagram”
    • 19.  
    • 20.  
    • 21. Health Economics
      • The scope of health economics is neatly encapsulated and dividing the discipline into eight distinct topics:
        • what influences health? (other than health care)
        • what is health and what is its value
        • the demand for health care
        • the supply of health care
        • micro-economic evaluation at treatment level
        • market equilibrium
        • evaluation at whole system level
        • planning, budgeting and monitoring mechanisms
      Alan William’s “plumbing diagram”
    • 22. What is Health?
      • Health is defined accordingly as:
        • the general condition of the body or mind, especially in terms of the presence or absence of illnesses, injuries, or impairments
        • the general condition of something in terms of soundness, vitality, and proper functioning
        • general well being - having the function of maintaining physical and mental wellbeing among the general public and the administration of medical and related services
        • good for people - promoting physical and mental wellbeing
    • 23. 1.What influences health? (other than health care)
      • Health is determined by the complex interactions between individual characteristics, social and economic factors and physical environments
      • Strategies to improve population health must address the entire range of factors that determine health
    • 24.
      • Important health gains can be achieved by focusing intervention on the health of the entire population (or significant sub-populations) rather than individuals.
      • Improving health is a shared responsibility that requires the development of healthy public policies in areas outside the traditional health system.
      • The health of a population is closely linked to the distribution of wealth across the population.
      Health Canada http://www.hc-sc.gc.ca/hppb/regions/ab-nwt/resources/present/index.htm
    • 25. Health Determinants:
      • Income and social status
      • Social support networks
      • Social environments
      • Education
      • Employment and working conditions
      • Physical environment
      • Gender
      • Culture
      • Personal health practices and coping skills
      • Healthy child development
      • Biology and genetic endowment
      Health Canada http://www.hc-sc.gc.ca/hppb/regions/ab-nwt/resources/present/index.htm
    • 26. Health Determinants: Income and Social Status
      • Social Status - refers to a person's rank or social position in relation to others - their relative importance.
        • ... affects health by determining the degree of control people have over life circumstances.
        • ... affects their capacity to act and make choices for themselves.
        • Higher social position and income somehow act as a shield against disease.
      • Income - with higher income, one has the ability to:
        • purchase adequate housing, food and other basic needs.
        • make more choices and feel more in control over decisions in life.
      • This feeling of being in control is basic to good health.
    • 27. Health Determinants: Social Support Network
      • Support from families, friends & communities is associated with better health.
      • The importance of effective responses to stress & having the support of family & friends provides a caring & supportive relationship that seems to act as a buffer.
    • 28.
      • Can affect:
        • psychological (emotional) health
        • physical health
        • health perceptions (how healthy one feels)
        • how individuals & families manage disease & illness
      • Social Supports in Communities:
      • These social units give & receive help:
              • Worksites
              • Schools
              • Families
              • Friends
              • Churches
              • parks
              • libraries
              • clubs & organizations
              • businesses
              • community colleges
      • The community is… a social influence that affects the health and well-being of individuals.
    • 29. Health Determinants: Social Environments
      • The array of values and norms of a society influence the health and well-being of individuals and populations in varying ways.
      • Social stability, recognition of diversity, safety, good working relationships, and cohesive communities provide a supportive society that reduces or avoids many potential risks to good health .
      • Studies have shown that low availability of emotional support and low social participation have a negative impact on health and well-being .
    • 30. Health Determinants: Education
      • On average, people with higher levels of education are more likely to:
        • be employed
        • have jobs with higher social status
        • have stable incomes
      • How education & health are related -
        • increases financial security
        • increases the choices & opportunities available
        • increases job security & satisfaction
        • improves "health literacy"
        • equips people with the skills [needed] to identify & solve individual & group problems
        • can unlock ... creativity & innovation in people, and add to our collective ability to generate wealth
    • 31. Health Determinants: Employment and Working Conditions
      • Unemployment & underemployment are associated with poorer health.
      • People with more control over their work circumstances and fewer stress-related demands on the job are healthier and often live longer than those in more stressful or more risky work.
      • Workshop hazards & injuries are significant causes of health problems.
    • 32.
      • The impact of Unemployment on Health -
        • People who have been unemployed for any significant amount of time tend to die earlier and have higher rates of suicide & heart disease.
        • Spouses of unemployment workers experience increased emotional problems . Children, especially teens, whose parents are unemployment are at higher risk of emotional and behavioral problems.
        • Recovery of physical & mental health after unemployment is neither immediate nor complete.
    • 33. Health Determinants: Physical Environments
      • The physical environment affects health both directly in the short term & indirectly in the longer term.
      • Good health requires access to good quality air, water, & food and freedom from exposure to toxins
      • In the longer term, if the economy grows by degrading the environment & depleting natural resources, human health will suffer. Improving population health requires both a sustained, thriving economy and a healthy, sustainable environment
    • 34.
      • The challenge is to maintain a thriving economy while preserving the integrity of the environment and the availability of resources.
      • Factors in the human-built environment such as the type of housing, the safety of our communities, workplace safety, road design are also important.
    • 35. Health Determinants: Gender
      • Gender influences health status
      • ... is linked more to the roles, power & influence society, gives to men & women, than it is to their biological differences.
      • Gender refers to the array of society-determined roles, personality traits, attitudes, behaviors, values, relative power & influence that society ascribes to the two sexes on a differential basis.
      • "Gendered" norms influence the health system's practices and priorities. Many health issues are a function of gender-based social status or roles.
      • Measures to address gender inequality and gender bias within & beyond the health system will improve population health.
    • 36. Health Determinants: Culture
      • Culture and ethnicity influence health.
      • It influences how people link with the health system, their access to health information and their lifestyle choices.
      • Culture & ethnicity are products of both personal history & wider situational, social, political, geographic, and economic factors.
      • Culture & ethnicity are important in shaping the way people interact with a health care system, their participation in programs of prevention & health promotion, access to health information, health related lifestyle choices, their understanding of health and illness and their priorities.
    • 37.
      • "Dominant" cultural values largely determine the social & economic environment of communities.
      • Some people face greater health risks due to:
        • marginalization
        • loss/devaluation of culture & language
        • lack of access to culturally appropriate health services
    • 38. Health Determinants: Personal Health Practices and Coping Skills
      • prevent disease
      • increase self-reliance
      • handle outside influences & stresses
    • 39.
      • Personal health practices are the individual decisions people make that affect their health directly.
        • These are behaviors people choose to do or not do in their daily lives. Some examples are: smoking, food choices and dietary habits, alcohol and drug use, and physical activity.
      • Coping skills are the ways people deal with a situation or problem.
        • Over their life, people develop skills that allow them to cope with the ups & downs of life. These coping skills are the internal resources people have to handle outside influences & pressures.
    • 40. Health Determinants: Healthy Child Development
      • The effect of prenatal and early childhood experiences on subsequent coping skills, competence and future well-being is very powerful.
      • Children born in low income families are more likely to have low birth weight, to eat less nutritious food and to have difficulties with health & social problems throughout their lives.
    • 41.
      • Healthy Child Development (HCD) means –
        • good physical health, including good nutrition
        • age-appropriate physical, mental & social development
        • the ability to make effective social connections with others
        • competence in culturally valuable skills and the opportunity to use them
        • good coping skills, including handling stress
        • control over one's life choices
        • a sense of being loved and belonging
        • healthy self-esteem
    • 42. Health Determinants: Biology and Genetic Endowment
      • The basic biology and organic make-up of the human body are a fundamental determinant of health.
      • Genetic endowment provides an inherited predisposition to a wide range of individual responses that affect health status.
      • Although socio-economic and environmental factors are important determinants of overall health, in some circumstances genetic endowment appears to predispose certain individuals to particular diseases or health problems.
    • 43. 2. What is health and what is its value ?
      • The General Wellbeing
      • - having the function of maintaining physical and mental wellbeing among the general public and the administration of medical and related services
      • “ Good” for people - promoting physical and mental wellbeing
    • 44.
      • Cost and Health Benefits
      • Medical care at the end of life, which is often is estimated to contribute up to a quarter of US health care spending, often encounters skepticism from payers and policy makers who question its high cost and often minimal health benefits
      • Medical resources are being wasted on excessive care for end-of-life treatments that often only prolong minimally an already frail life
      • There exists no positive theory that attempts to explain the high degree of end-of life spending and why differences across individuals, populations, or time occur in such spending
      “ The Value of Life Near its End and Terminal Care ”, Gary Becker, Kevin Murphy, and Tomas Philipson
    • 45.
      • Misallocation of resources induced by excessive end of life health care has important consequences for the overall economy
      • Several forces operate in allocating resources towards extending life at its end that implies that the value of extending life in those situations appear larger than those estimated in the existing literature.
        • First, if resources have no value when dead
        • Second, we argue that an important ignored component of spending on end-of-life care concerns preserving “hope” of living, and that preserving hope raises valuation.
        • Third, the social value of a life is often greater than the private value of the same life.
        • Fourth, we argue that rational terminal care often is larger for frail patients than commonly argued.
      “ The Value of Life Near its End and Terminal Care ”, Gary Becker, Kevin Murphy, and Tomas Philipson
    • 46. 3. The demand for health care
      • Health Care is a complex “good”, one reason why health care delivery is a complex policy area.
      • The demand for health care is uncertain, since the occurrence of disease cannot be adequately predicted.
      • Health care is characterized by low degree of substitutability and is not wanted for its own sake but sought as an alternative to the discomforts of illness.
      “ Issues and Initiative in Health Care”. Oscar F Picaso. Development Research News, Vol. VIII, No. 2, March – April, 1990, pp. 1 – 4, 11 – 12.
    • 47.
      • Patients are generally unaware of treatment alternatives or maybe aware but not capable of evaluating them
      • The virtual “medical ignorance” of patients
      • The presence of many providers and the patient’s ability to choose significantly reduces the occurrence of doctor-determined demand
      “ Issues and Initiative in Health Care”. Oscar F Picaso. Development Research News, Vol. VIII, No. 2, March – April, 1990, pp. 1 – 4, 11 – 12.
    • 48.
      • Health is both a consumption and investment good
      • - as consumption commodity, health makes people feel better
      • - as an investment in human capital formation which yield an incremental flow of future income or output
      • Health improvement exerts both quantity and quality effects on labor supply.
      • Consumers demand good health because a decrease in the number of sick days will determine the amount of time for leisure and work.
      “ Issues and Initiative in Health Care”. Oscar F Picaso. Development Research News, Vol. VIII, No. 2, March – April, 1990, pp. 1 – 4, 11 – 12.
    • 49.
      • Health Care does not necessarily depend on its money price nor on household income.
      • Poverty and health care cost have little to do with services.
      • Demand studies are immensely important in the formulation of health policies.
      • - whether it is prudent to impose user fees on health service
      “ Issues and Initiative in Health Care”. Oscar F Picaso. Development Research News, Vol. VIII, No. 2, March – April, 1990, pp. 1 – 4, 11 – 12.
    • 50.
      • One last aspect: The distinction between the demand and need
      • - under conditions of pervasive poverty and supply constraints, demand do not suffice and need maybe the more appropriate concept.
      • e.g. a sick man maybe medically in need but may not seek medical care and utilize a service for one reason or another
      “ Issues and Initiative in Health Care”. Oscar F Picaso. Development Research News, Vol. VIII, No. 2, March – April, 1990, pp. 1 – 4, 11 – 12.
    • 51. 4. The supply of health care
      • Health Care is one of the most complicated services to produce.
      • Factors of health services production:
        • medical and allied personnel
        • drug and other health products
        • equipment and other capital investments
        • utilities and other intermediate goods
      “ Issues and Initiative in Health Care”. Oscar F Picaso. Development Research News, Vol. VIII, No. 2, March – April, 1990, pp. 1 – 4, 11 – 12.
    • 52. Supply of Health Care: Manpower
      • The Philippines produces considerable number of medical and allied health manpower, and is one of the major exporter of physicians, nurses, and dentists, causing shortages of these professionals in many areas in the country.
      • To address issues on the correspondence between the medical and nursing curricula with the requirement of health care delivery system, the legal aspects of professional practice and task delegation, the development of career paths, appropriate incentives to attract manpower in the rural areas, and the optimum number of health manpower exports taking into consideration the country’s needs.
      “ Issues and Initiative in Health Care”. Oscar F Picaso. Development Research News, Vol. VIII, No. 2, March – April, 1990, pp. 1 – 4, 11 – 12.
    • 53. Supply of Health Care: Drugs and other Health Products
      • The National Drug Policy – the use of generic names in the prescriptions, sale and dispensation of drugs.
      • The Health Product Development Group (HPDG) – organized since August 1989, reviews the consumption of these products, and the possibility of manufacturing locally; obtain information on the feasibility and cost-effectiveness of local manufacture of specific health products.
      • Provide guidance on how health care technologies can be developed, selected and rationally allocated to improved quality of care.
      “ Issues and Initiative in Health Care”. Oscar F Picaso. Development Research News, Vol. VIII, No. 2, March – April, 1990, pp. 1 – 4, 11 – 12.
    • 54. Supply of Health Care: Medical Equipment
      • All sophisticated equipment in the Philippines are imported.
      • No policies govern their importation, distribution, and use.
      • Its high cost has establish a capacity for the determination of needs, as well as for technology assessment, allocation, monitoring and operation of these capital resources.
      • Business entities have shown interest in providing medical equipment to government and private hospitals through a variety of new arrangements, e.g. capital lease, operating lease, and “per use” basis.
      “ Issues and Initiative in Health Care”. Oscar F Picaso. Development Research News, Vol. VIII, No. 2, March – April, 1990, pp. 1 – 4, 11 – 12.
    • 55. 5. Micro-economic evaluation at treatment level
      • Economic evaluation is the comparison of two or more alternative courses of action in terms of both their costs and consequences
      • Economists usually distinguish several types of economic evaluation, differing in how consequences are measured
      Drummond, et. al
    • 56. Micro-economic evaluation at treatment level
      • Economists usually distinguish several types of economic evaluation, differing in how consequences are measured
      • Cost minimisation analysis
      • Cost benefit analysis
      • Cost-effectiveness analysis
      • Cost-utility analysis
    • 57.
      • In cost minimisation analysis (CMA), the effectiveness of the comparators in question must be proven to be equivalent
      • The ' cost-effective ' comparator is simply the one which costs less (as it achieves the same outcome)
      • In cost-benefit analysis (CBA), costs and benefits are both valued in cash terms
      • In cost effectiveness analysis (CEA) measures outcomes in 'natural units', such as mmHg, symptom free days, life years gained
      • Cost-utility analysis (CUA) measures outcomes in a composite metric of both length and quality of life, the Quality Adjusted Life Year (QALY)
    • 58. Cost of Illness Study
      • not a true economic evaluation as it does not compare the costs and outcomes of alternative courses of action
      • it attempts to measure all the costs associated with a particular disease or condition
      • Includes:
        • direct costs (where money actually changes hands, e.g. health service use, patient co-payments and out of pocket expenses)
        • indirect costs (the value of lost productivity from time off work due to illness)
        • intangible costs (the 'disvalue' to an individual of pain and suffering)
    • 59. 6. Market equilibrium
        • Health care markets
        • Competitive equilibrium in the five health markets
        • Efficiency vs. equity
        • Ideological bias in the debate about the financing and delivery health markets
        • Evaluation at a whole system level
        • Planning, budgeting, and monitoring mechanisms
    • 60. Market Equilibrium: Health Care Markets
      • Healthcare financing market
      • Physician and nurses services market
      • Institutional services market
      • Input factors market
      • Professional education market
    • 61.
      • Consumers in health care markets often suffer from a lack of adequate information about what services they need to buy and which providers offer the best value proposition
      • Health economists have documented a problem with "supplier induced demand", whereby providers base treatment recommendations on economic, rather than medical criteria
      • Researchers have also documented substantial "practice variations", whereby the treatment a patient receives depends as much on which doctor they visit as it does on their condition
      • Both private insurers and government payers use a variety of controls on service availability to rein in inducement and practice variations
    • 62. Market Equilibrium: Competitive Equilibrium in Five Health Markets
      • Market failures occur in the financing and delivery markets due to two reasons :
        • Perfect information about price products is not a viable assumption
        • Various barriers of entry exist in the financing markets (i.e. monopoly formations in the insurance industry)
    • 63. Market Equilibrium: Efficiency vs. Equity
      • Its implications are that competitive markets will always be efficient
      • Local non-satiation of consumer preferences
      • It is that assumption that is often violated in the first two of the health markets
      • The government deems it to be inequitable due to vast health disparity or lack of basic healthcare services.
    • 64. Market Equilibrium: Ideological bias in the debate about the financing and delivery health markets
      • The healthcare debate in public policy is often informed by ideology and not sound economic theory
      • The ideological spectrum spans: individual savings accounts and catastrophic coverage, tax credit or voucher programs combined with group purchasing arrangements, and expansions of public-sector health insurance
    • 65. 7. Evaluation at whole system level
      • Input and Output
      • Demands
      • Cost
      • Gain:
        • Benefits
        • Income
      • Expansion and Upgrading
    • 66. 8. Planning, budgeting and monitoring mechanisms
      • Planning and budgeting for health system strengthening can be used alone or to complement the existing disease specific costing tools
      • e.g. malaria, TB, HIV/AIDS, making pregnancy safer, child health and immunization
      • To take into account the health systems costs necessary for executing the proposed disease specific interventions
    • 67.
      • Monitor trends in health spending for all sectors - public, private and external. Helps to tracks where the money comes from, how it is pooled and how it is spent for different health care activities
      • Monitor the level and distribution of household financial burden and poverty impact due to out-of-pocket health payments; identify households vulnerable to catastrophic health expenditure
    • 68.
      • Explores health insurance policy options, ensuring financial viability and illustrating equity implications
      • To analyze performance of a health financing system and its respective health financing schemes by assessing key design issues and implementation, identify bottlenecks in the way institutions and organizations function and help in finding institutional and organizational alternatives and solutions to improve health systems performance
      • To inform priority-setting and resource allocation in the health sector via the generation of intervention cost-effectiveness estimates for all leading contributors to disease burden, both at regional and country level
    • 69.  
    • 70.  
    • 71. Sectoral Management & Coordination Team Internal Management Support Team Governance & Management Support Policy & Standards Development & Technical Assistance Field Implementation & Coordination Policy & Standards Development Team for Regulation Field Implementation & Coordination Team for Luzon & NCR Field Implementation & Coordination Team for Visayas & Mindanao Secretary of Health National Health Planning Committee Attached Agencies & Special Concerns Management Arrangements for Implementation Regional Implementation & Coordination Teams Regional Implementation & Coordination Teams Policy & Standards Development Team for Service Delivery Policy & Standards Development Team for Financing
    • 72. Other Issues: Medical Economics
      • Medical Economics – synonimously with Health Economics, is the branch of economics concerned with the application of economic theory to phenomena and problems associated typically with the second and third health market outlined above ( Physician and nurses services market and Institutional services market)
      From Wikipedia, the free encyclopedia
    • 73. Medical Economics
      • It pertains to cost-benefit analysis of pharmaceutical products and cost-effectiveness of various medical treatments
      • Medical economics often uses mathematical models to synthesise data from biostatistics and epidemiology for support of medical decision making, both for individuals and for wider health policy.
    • 74.
      • Designing policy options to cover the uninsured that are efficient and equitable; assessing the relative merits of alternative financing options, including their effect on work incentives, productivity, and the distribution of the cost burden across the population.
      • Analysis of state health spending and flow of funds: analysis of total state spending, sources of payment, and the impact on the state economy of policy changes.
      • Analysis of health care trends-examining the forces driving health care spending, the restructuring of the health care delivery system, and new developments in federal and state government health care programs.
    • 75.
      • Analysis of state insurance regulation and effects on risk sharing, access to coverage, and total insurance coverage rates.
      • Use of purchasing pools/insurance exchanges to facilitate cost-effective purchase of insurance coverage.
      • Helping hospital systems and other major providers understand how emerging public policies and changing market developments will affect their financial viability.
      • Working with managed care organizations to assess potential new markets and the likely impact of new developments in government programs.
    • 76.
      • WHO Resources:
      • 1. Strengthening Health Management in Districts and Provinces A. Cassels and KJanovski, 1995 Handbook, health management teams, process, problem identification, developing solutions, planning action, implementing and evaluating achievements.
      • 2. Planning and Implementation of District Health Services (Module 4) Rufaro Chatora and Prosper Tumusiime, 2004, WHO Regional Office for Africa, AFR/DHS/03.04 10 steps in planning, essential health package, health systems research, disaster preparedness
      • 3. How to Manage The Finances of Your Healthcare Technology Management Teams [pdf 944kb] Willi Kawohl, et. al, 2005 Financial management cycle; operational plan and targets; budget process and format; activity-based accounting; financial monitoring tools and reports; financial decisions and action
      • 4. Cost Analysis in PHC: A Training Manual for Programme Managers Andrew Creese and David Parker (ed.), 1994 Identification and calculation of costs, accountability, efficiency, equity, effectiveness, indicators, economic costs, household costs, managerial efficiency
      • 5. How to Plan and Budget for Your Healthcare Technology [pdf 1.89Mb] Caroline Temple-Bird, Willi Kawohl, Andreas Lenel and Manjit Kaur, 2005 Equipment inventory; stock value; usage of consumables; model equipment lists; purchasing, donations, replacement and disposal policies; generic equipment specifications; purchasing and replacing equipment; installation; operating and maintenance costs; training; long-term equipment plans;
      • 6. District Health Facilities: Guidelines for Development and Operations WHO Regional Office for the Western Pacific, 1998 Hospitals planning and design, selection and maintenance of hospital resources, solutions
      • 7. Learning to Live with Health Economics (Edited by H. Zöllner, G. Stoddart and C. Selby Smith, 2005, WHO Regional Office for Europe Web page with links to 6 learning modules: 1) Introduction (2) Economics of health (3) Economics of health system development (4) Economics of management and the process of change (5) Useful economic tools (6) Economics as a tool for leaders.
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    • 79. Thank You ! Dr. Ronald Sanchez - Magbitang