1. Globalization and Health Care Systems
International Healthcare policy
1.1

2. Globalization and Health Care Systems
•Global Health Care Management Experience
•Study tour 2005 (US, Canada, Mexico,UK and
Australia)
•All countries in the Americas
•Partnerships Europe, CEE and NIS
(Hospitals, Managed Care, Health Systems, Health
Reform, Education and training on health services
management [human resources development,
institutional strengthening])
•Managerial and Health Services Research Perspectives
•Globalization impact in health and health care services
and management
•Health systems reform strategies with issues like
competitiveness, state regulations, insurance
companies, public private partnerships and patient
empowerment
•Quality, safety and performance improvement
•Value and impact of heath care. Chronic Care

3. Examples of global issues in
healthcare include:
 Outsourcing of medical services (e.g. medical
transcribing, radiology, billing support – similar to other
businesses)
 Acquisitions and consolidations in the pharmaceutical
industry
 Movement of health professional labor across national
borders
 Medical tourism; competition for international patients
 Immigration and global workforce
 Global health – pandemics (e.g. HIV/AIDS, Avian flu,
SARS)
 Comparative Health Systems and Health Reforms

4. Health Services Elements
• Resources
– Physical Resources, (hospitals, clinics, privatepublic, Ambulatory services)
– Equipment/Technology, Medicines
– Human resources (Education, health
manpower, Incentives, training, continuing
education, Physicians, nurses, technicians and
emerging professions)
– Financial Resources (Resource allocation,
budgets, financial schemes, reimbursement,
insurance mechanisms)

5. Health Services Elements
• Health Services
– Primary/Secondary health care. Systems.
– Management Information Systems
– Clinical Standards and Protocols. Safety Issues.
– Quality Assurance and Quality Improvement
– Legal aspects (malpractice)
– Incentives, Performance management.
– Cost or services
– Efficiency, clinical & Management efficiency
– Effectiveness, Health Impact and outcomes

6. Types of Health Care Services
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Traditional, spiritual, empirical
Charitable and altruistic organizations
Entrepreneurial Private practice
Welfare-oriented, social insurance
Government and centrally planned
Prepaid voluntary insurance
Owned by industry for their workers

7. Origins of Health Care Systems
– England. Chadwick report on laboring conditions. Boards of
Public Health (1850). Mandatory Insurance for workers
(1911) Welfare State Beveridge Report (1942), NHS (1948)
– Germany. Bismarck, Mandatory insurance for injury and
illness (1883)
– Central Planning Concept: Semashko. (1923)
– Mixed Systems from tax-free health care in Saudi Arabia to
combination of public-private

8. Health Sector Reforms Around The World
• Balance the Iron Triangle (Access-Quality-Cost)
• Reorient MOH (make them smaller or more
functional, performance, accountability,
modernization, separate provision from financing,
competition, Chronic-Acute Care)
• Institute user charges-Accountability• Institute or expand health insurance schemes
• Decentralize-Empowerment
• Third party Contracts with private/public providers

9. Sustainability:
The capacity of health services to function with
efficiency, including the financial, environment
and social interaction that guaranties an effective
service now and in the future, with a minimum of
external intervention and without limiting the
capacity of future generations to fulfill their
needs.

10. Sustainability:
The capacity of health services to function with
efficiency, including the financial, environment
and social interaction that guaranties an effective
service now and in the future, with a minimum of
external intervention and without limiting the
capacity of future generations to fulfill their
needs.