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Title Name Amity Solved Assignment PGDM HA 1st Sem Introduction to Health System
University AMITY
Service Type Assignment
Course PGDM-(Hospital-Administration)
Semister Semester-I Cource: PGDM-(Hospital-Administration)
Short Name or Subject Code Introduction to Health System
Commerce line item Type Semester-I Cource: PGDM-(Hospital-Administration)
Product Assignment of PGDM-(Hospital-Administration) Semester-I (AMITY)

Solved Assignment


  Questions :-

                                                                                Amity PGDM In Hospital Administration For Introduction to Health System Sem 1

Assignment A

1 .        What is the concept of public and private healthcare?

2 .        Discuss the role of changing scenario in health care.

3 .        What is the concept of International Health?

4 .        What is Maternal and Child Health (MCH) program?

5 .        Describe the health care facilities to cure Tuberculosis available in India.    

6 .        Define systematic view of health care.

7 .        Describe the cost and quality of care in the private sector.   

8 .        Describe the delivery of health care services in India.

 

 

 

Assignment B

Case Detail: 

There is no CASE STUDY answer the following question 

1.         What is the role of hospital administrator system? Discuss in detail.

2.         Discuss the role of changing scenario in health care.

3.         Discuss International Health Governance in detail. 

 

 

 

Assignment C

Question No.  1           Marks - 10

Which care has become one of India´s largest sectors - both in terms of revenue and employment?

Options           

  1. Health
  2. Finance
  3. Agricultural    
  4. Medicine

 

Question No.  2           Marks - 10

According to National Family Health Survey-3, the private medical sector remains the primary source of health care for ------- of households in urban areas. 

 Options          

  1. 60%    
  2. 80%    
  3. 70%    
  4. 50%

 

Question No.  3           Marks - 10

The --------- sector has emerged as a vibrant force in India´s healthcare industry.

 Options          

  1. Public 
  2. Private
  3. Modern          
  4. Specialized

 

Question No.  4           Marks - 10

Which healthcare sector is responsible for the majority of healthcare in India?

 Options          

  1. Modern          
  2. Public 
  3. Private
  4. Specialized

 

Question No.  5           Marks - 10

Which would provide universal health coverage throughout India?             

 Options          

  1. Strivers           
  2. Makers
  3. Believers
  4. Plans

 

Question No.  6           Marks - 10

International health, also called geographic medicine or --------- health is a field of health care.

 Options          

  1. Global
  2. Regional         
  3. State   
  4. State

 

Question No.  7           Marks - 10

The International Health Regulations (IHR) is an international legal instrument that is binding on -------countries across the globe. 

 Options          

  1. 198     
  2. 196     
  3. 178     
  4. 176

 

Question No.  8           Marks - 10

In which Country cholera epidemics hit, in 1830 and 1847 made apparent the need for international cooperation in public health.

 Options          

  1. India   
  2. Europe
  3. England          
  4. France

 

Question No.  9           Marks - 10

Who divided International health organizations into three groups: multilateral organizations, bilateral organizations, and non-governmental organizations (NGOs).

 Options          

  1. MGO  
  2. KPO   
  3. NGO  
  4. WHO

 

Question No.  10         Marks - 10

An international society committed to improving global health – particularly regarding ------------- diagnosis, treatment and control.

 Options           

  1. Physical Health
  2. Mental Health
  3. Tuberculosis
  4. Dental

 

Question No.  11         Marks - 10

A --------- hospital typically is the major health care facility in its region.     

 Options          

  1. District           
  2. Private
  3. Public 
  4. Specialized

 

Question No.  12         Marks - 10

Who visited India during the time of Chandagupta and provides us details about the charitable dispensaries in Pataliputra. 

 Options          

  1. Romein
  2. Fa-hien           
  3. Hiuen 
  4. Chein

 

Question No.  13         Marks - 10

Caraka-samhita is a classical book of ------------system of medicine.

 Options          

  1. Unani 
  2. Ayurvedic      
  3. Siddha
  4. Indian

 

Question No.  14         Marks - 10

Which hygiene is the science and practice of the recognition, treatment, and prevention of oral diseases?

 Options          

  1. Eye     
  2. Ear      
  3. Mental
  4. Dental

 

Question No.  15         Marks - 10

In which year, Ferlie and Shortell, divided the health care system is into four “nested” levels.

 Options          

  1. 2003   
  2. 2002   
  3. 2001   
  4. 2004

 

Question No.  16         Marks - 10

Malaria is probably one of the --------- diseases known to mankind.

 Options          

  1. Oldest
  2. New   
  3. Ancient          
  4. Modern

 

Question No.  17         Marks - 10

According to National AIDS Control Organization of India, the prevalence of AIDS in India in ------------- was 0.27. 

 Options          

  1. 2011   
  2. 2013   
  3. 2012   
  4. 2010

 

Question No.  18         Marks - 10

In which year the Government of India launched the National Mental Health Program (NMHP)?

 Options          

  1. 1983   
  2. 1982   
  3. 1985   
  4. 1986

 

Question No.  19         Marks - 10

The vast majority of ------infections in India occur through sexual transmission.     

 Options          

  1. Mental
  2. HIV    
  3. Fungal
  4. Bacterial

 

Question No.  20         Marks - 10

Tuberculosis (TB) is an infectious disease caused by a Bacterium, -----------------tuberculosis.

 Options          

  1. Salmonella      
  2. Staphylococcus          
  3. Mycobacterium          
  4. Escherichia

 

Question No.  21         Marks - 10

Which of the following determinants of health is a ´downstream´ determinant?      

 Options          

  1. Housing          
  2. Employment conditions         
  3. Age    
  4. Education

 

Question No.  22         Marks - 10

In a population of 10,000,000 people, at a given time 500 individuals have motor neurone disease. What is the point prevalence of motor neurone disease in this population at this given time?  

 Options          

  1. 0.05 per 100,000        
  2. 0.5 per 100,000          
  3. 5 per 100,000 
  4. 50 per 100,000

 

Question No.  23         Marks - 10

Which of the following is not commonly considered to be part of the public health function of community pharmacists?   

 Options          

  1. Health promotion       
  2. Compounding
  3. Diabetes testing         
  4. ´Sign-posting´

 

Question No.  24         Marks - 10

Which of the following does not currently present a significant health challenge in low-income countries?           

 Options          

  1. HIV/AIDS     
  2. Malaria           
  3. Cardiovascular disease           
  4. Diarrhoeal diseases

 

Question No.  25         Marks - 10

Which of the following recommendations to combat diabetes may be unfeasible in very urban environments?     

 Options          

  1. Eat more fresh fruit    
  2. Do 25 jumping-jacks every morning  
  3. Go out for a walk every day  
  4. See your dietitian at least twice a year.

 

Question No.  26         Marks - 10

How can physicians help patients from rural communities control their diabetes and overcome barriers in health care?           

 Options          

  1. By identifying diabetic outreach programs and traveling clinics.     
  2. By providing medical pamphlets regarding diabetes.
  3. By referring patients to a local dietitian        
  4. By encouraging daily exercise.          

 

Question No.  27         Marks - 10

What percentage of body weight lost represents the threshold in modifying risk factors for metabolic syndrome?           

 Options          

  1. 20–25%.         
  2. 15–20%.         
  3. 10–15%.         
  4. 5–10%.

 

Question No.  28         Marks - 10

Fear of deportation among undocumented Hispanic immigrants may lead to which of the following results?       

 Options          

  1. Delayed medical treatment    
  2. Complete disclosure of relevant medical information.          
  3. Decreased risk in asthma morbidity.  
  4. Increased patient interest in personal health

 

Question No.  29         Marks - 10

The belief that asthma treatment can lead to addiction is prevalent among which of the following groups?          

 Options          

  1. Chinese Americans    
  2. Dominican Americans.           
  3. Mexican Americans   
  4. Columbian Americans

 

Question No.  30         Marks - 10

Which of the following abilities is promoted through the use of trained medical interpreters?        

 Options          

  1. Ability to have “small talk” with patients      
  2. Ability to diagnose psychosocial disorders.  
  3. Ability to address adherence issues.  
  4. Ability to educate patients about their medications. 

 

Question No.  31         Marks - 10

Disparities in effective pain management for racial and ethnic minorities appear most frequently under which of the following settings?     

 Options          

  1. Rehabilitation therapy
  2. Physical therapy         
  3. Cancer therapy           
  4. Preoperational therapy

 

Question No.  32         Marks - 10

Suspicion of which of the following behaviors may affect pain management plans, especially for patients with sickle cell disease?   

 Options          

  1. Spousal abuse 
  2. Heavy smoking.         
  3. Recreational drug abuse         
  4. Narcotic dependence.

 

Question No.  33         Marks - 10

Health care decision making regarding children and adolescents under the age of 18 years should ultimately strive to develop which of the following?       

 Options          

  1. Ensure that the patient is informed and assents to the plan of care. 
  2. Deferral of invasive procedures until the patient reaches the age of consent.           
  3. Identification of an independent patient advocate outside of the family     
  4. Legal emancipation of the minor patient so he/she can make his/her own decisions.

 

Question No.  34         Marks - 10

Which of the following approaches is most appropriate when discussing illicit drug use with patients?     

 Options          

  1. Asking the patient when he/she last used drugs        
  2. Ordering blood work without addressing the issue with the patient
  3. Framing a question in a nonaccusatory and nonjudgmental manner 
  4. Discussing the issue with the patient’s family instead of the patient.

 

Question No.  35         Marks - 10

Which of the following factors is most likely to contribute to the minimization of the significance of a patient’s symptoms by a health care provider? 

 Options          

  1. Middle age     
  2. Female gender
  3. High income   
  4. Caucasian race

 

Question No.  36         Marks - 10

Which of the following lifestyle changes is most likely to decrease a patient’s risk of coronary heart disease?      

 Options          

  1. Switching from 2% milk to 1% low-fat milk 
  2. Exercising on a daily basis     
  3. Taking a multivitamin supplement.    
  4. Cutting back on work schedule.

 

Question No.  37         Marks - 10

Which of the following is an ethical obligation of physicians?         

 Options          

  1. Patience.         
  2. Veracity.        
  3. Mercy.
  4. Honor.

 

Question No.  38         Marks - 10

What is an appropriate treatment option for HIV patients in the first trimester of pregnancy?        

Options          

  1. Treatment is usually delayed until the 2nd trimester 
  2. Both oral and intravenous AZT         
  3. Intravenous AZT       
  4. Oral AZT

 

Question No.  39         Marks - 10

Which of the following statements about health care in Ecuador and other Latin American countries is true?       

 Options          

  1. Pharmacists may give medical treatment without a physician’s prescription
  2. Sharing medication among family members is rare in Latin American countries.     
  3. Few drugs are dispensed without medical prescriptions       
  4. Choosing medications is usually left up to the individual

 

Question No.  40         Marks - 10

Prior to a diabetic patient’s extended overseas vacation, which of the following questions about traveling must be asked  

 Options          

  1. Will you be staying in the city or in the countryside 
  2. What is the climate like there during this time of year          
  3. When was the last time you visited your home country        
  4. Do you have a primary care doctor in your home country for an emergency
  Answers :-

                                                                                                                                            Introduction to Health System

Assignment A

1.What is the concept of public and private healthcare?

ANS   Public and private healthcare systems

New Zealand has both a public and private healthcare system, and both offer high standards of care.

In the public system, essential healthcare services are provided free for all New Zealanders and people in New Zealand on a work permit valid for two years or longer.

Alongside the public system, private healthcare offers access to private hospitals for the treatment of both urgent and non-urgent conditions (excluding Accident and Emergency Care). The network of private hospitals and clinics provides a range of services that include recuperative care, elective procedures and a range of general surgical procedures. There are also private radiology clinics and testing laboratories.

The public system

The government-funded public health system works on a community-oriented model, with three key sectors.

  • District Health Boards - District Health Boards (DHBs) are funded by the government and are responsible for providing or funding health and disability services in their district.
  • Primary Health Care - Primary health care covers a broad range of out-of-hospital services, although not all of them are government funded. Primary health care includes first level services such as general practice, mobile nursing and community health services.
  • PHOs (Primary Health Organisations) - PHOs are the local structures for delivering and co-ordinating primary health care services. PHOs bring together doctors, nurses and other health professionals (such as Māori health workers, health promotion workers) in the community to serve the needs of their enrolled patients.

The private system

Private healthcare in New Zealand includes specialist services, primary care and private hospitals which provide non-urgent and elective treatments that complement the public health service´s focus on urgent and essential treatments.

There are also many private accident, emergency and medical clinics that operate in the private sector, often providing services outside the usual hours of doctors and clinics in the public system.

 

 

2.Discuss the role of changing scenario in health care.

ANS    The Indian healthcare industry is all set to grow to over USD 280 billion by 2020, which is a growth of over ten times from 2005. This growth has been driven by several factors, including demographics, increase in awareness levels and availability of medical care in India. –

Changing with the times

Conducive demographics: While the population growth rate for India has steadily gone down, it is still at over 1.3 percent and is not expected to go below one percent in the near future. Also, it is interesting to note that our population aged above 60 years is projected to grow to around 193 million, compared with over 96 million in 2010. This change in the population pyramid is expected to fuel the demand for healthcare in general, particularly lifestyle diseases.

Rising affordability: In the past decade, India has witnessed a rapid increase in levels of wealth and disposable incomes. Coupled with a better standard of living and health awareness, this has led to an increase in spending on healthcare and wellness.

Increase in lifestyle diseases: Lifestyle-related diseases comprised 13 percent of total ailments in India, according to a 2008 data, and this number is expected to increase to 20 percent by 2018. This is expected to trigger an additional demand for specialised treatment, which in turn, will lead to increased margins for hospitals since these diseases lie at the high margin end of the spectrum.

Challenges to growth

Despite such strong factors working in the industry’s favour, there are several systemic challenges that also need to be addressed.

Dual disease burden: Even asthe incidence of lifestyle diseases is steadily on the rise, a vast majority of rural and poor patients still suffer from infectious and acute diseases.

Low penetration of insurance and other payer mechanisms: The overall quantum of health insurance may have increased, but it is largely limited to urban areas. In other areas, especially rural, people continue to spend from their own pockets.

Patient/consumer centric healthcare

Given the nature of the healthcare ecosystem in India, several hospitals and other health facilities are waking up to the need for ‘patient-centric care’. At the core of this approach is the customer or the patient. It links multiple levels of care management, coordinates services and encourages professional collaboration across a range of care delivery.

Integrated healthcare is another approach that is being increasingly used. It is not about structures or common ownership or bearing insurance risk, but about networks and connections, often between separate organisations, that focus the continuum of healthcare delivery around patients and populations. The models of integrated healthcare vary from entailing contracts with private providers to legislation driven approaches.

The connected health ecosystem

This approach to healthcare delivery leverages the systematic application of healthcare information technology to facilitate the accessing and sharing of information, as well as to allow subsequent analysis of health data across systems. The ambition of connected health is to connect all parts of a healthcare delivery system, seamlessly, through interoperable health information processes and technologies so that critical health information is available when and where it is needed.

By structuring and exchanging healthcare information to center care delivery around the patient or a defined population, connected health facilitates improved care coordination, disease management, and the use of clinical practice guidance to help reduce errors and improve care.

The journey to connected health

There are three milestones on the journey to connected health:

  1. Healthcare IT adoption: The planning, construction and use of a digital infrastructure.
  2. Health information exchange: The exchange of captured health information between clinicians, across administrative groups and with patients.
  3. Insight driven healthcare: The use of advanced analysis of data to better inform clinical decision making, population health management and the creation of new care delivery models.

 

 

3.What is the concept of International Health?

ANS   The growing interconnectedness of countries via worldwide economic markets has shifted attention from comparing health between nations (i.e., internationally) toward reviewing global influences on health. The paradigm shift moves attention from questions of national policies toward global issues such as climate change, population growth, environmental degradation, food security, energy supply, etc. Global issues are seen as "determinants of the determinants of health."  Solutions will require global collaboration, and innovations in one place can be shared with others.

Globalization refers to "a process of greater integration within the world economy through movements of goods and services, capital, technology, and (to a lesser extent) labor, which lead increasingly to economic decisions being influenced by global conditions" - the emergence of a global marketplace. Our increasingly global economy influences social and cultural factors that, in turn, affect health. For example, the global marketing of Coca Cola or McDonald´s affects diet which in turn influences obesity in the world. (See Ted Schrecker & Ron Labonté: "Globalization and social determinants of health")

Global health refers to "Health problems, issues and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions" (U.S. Institute of Medicine, 1997). Note, however, that there is some debate over precisely how to define global health. A discussion in the Lancet (vol 373, 6 June 2009, page 1993) notes: ". . . global refers to any health issue that concerns many countries or is affected by transnational determinants, such as climate change or urbanisation, or solutions, such as polio eradication. Epidemic infectious diseases such as dengue, influenza A (H5N1), and HIV infection are clearly global. But global health should also address tobacco control, micronutrient deficiencies, obesity, injury prevention, migrant-worker health, and migration of health workers. The global in global health refers to the scope of problems, not their location…”

The following examples illustrate a global health perspective:

 

Health Issue

Global Perspective

Cigarette smoking

Tobacco is ranked as the second major cause of death in the world

Tobacco is a multinational business with global marketing strategies. Illicit tobacco marketing is also important

Obesity

One billion adults worldwide are overweight; 300 million are clinically obese

Food retailing and marketing is a multinational business

STIs

340 million new cases of sexually transmitted infections occur world wide each year

Increased travel and migration contribute to the spread of STIs; global action is required to coordinate containment efforts

Mental health

450 million people worldwide are affected by mental illness at any one time

Conflict and poverty are major contributors; these generally involve more than a single country and intervention strategies require multinational collaboration

Alcohol

76.3 million people worldwide have alcohol use disorders

Alcohol marketing and distribution is a global business; lessons can be learned from other countries

Inequities

A major driving force that underlies most health patterns is the level of inequality between people. Disparities in power and wealth directly influence health

While inequalities and inequities in societies are great, there are much greater disparities between countries. Life expectancy in Sierra Leone is less than half that in Japan

 

 

 

4.What is Maternal and Child Health (MCH) program?

 Ans: Materials & Child Health

Maternal and child health is a dynamic field that aims to improve the health of women, children, youth, and entire families and communities, while addressing health inequities and the systems and policies that contribute to family health. Women’s health across the lifespan; sexual and reproductive health and justice; the perinatal period and birth outcomes; inter-conception care; child health, including mental health and special needs; and youth and adolescent development and health are some of the many maternal and child public health challenges. The maternal and child health field uses a life course perspective to address these issues, combining an understanding of human development and the social determinants of health as they accumulate and interact across the lifespan and across generations.

The Master of Public Health with a concentration in Maternal & Child Health is directed at students who seek to protect and enhance the health and well-being of women, children, and families. Students explore the unique physical needs of this population through coursework in maternal and infant health, child and adolescent health, and community-based needs assessment in maternal and child health. They then place this knowledge into a sociopolitical context, obtaining a comprehensive understanding of the cultural influences affecting women, children, and the larger community. Outside of coursework, students may participate in departmental research, the Maternal & Child Health fellowship program, the Maternal & Child Health Diversity Scholars Program, and the MCH Leadership Program. Graduates are equipped for careers in community and global health organizations, advocacy groups, and government agencies that address compelling issues in maternal and child health.

Special Educational Programs

The MCH department hosts two special educational program that combine MCH courses with leadership development. Students are selected for these programs through an application process during their studies.

Your advisor can help you decide if a program is right for you. For detailed information on both programs, please visit the Maternal & Child Health Concentrator’s Guide.

Prospective students should contact the Maternal & Child Health staff for additional information.

Diversity Scholars Program

The Maternal & Child Health Diversity Scholars Program is designed to increase the number of health professionals from underrepresented minority populations who can address the long-standing gaps in the health of women and children within minority communities and work toward the elimination of health disparities. The program offers alumni mentoring, leadership training, and specialized course work for concentrators who are from underrepresented minority communities. The set of required courses covers the areas of Cultural Competency and Health Disparities; Program Development and Management; Research and Evaluation; and Policy and Advocacy. This interdisciplinary series is led by Maternal & Child Health faculty, Diversity Scholar Program Mentors, and area Maternal & Child Health leaders. Diversity Scholars will be awarded a scholarship covering up to half of their tuition and requires at least two years of residency in the Maternal & Child Health MPH Program. Applications are available to new Maternal & Child Health Concentrators at the start of their MPH education.

Maternal & Child Health Leadership Education Program

This program is designed for aspiring leaders in the field of maternal and child health. It combines courses designed to build competencies in program design, management, evaluation, policy analysis, and advocacy; the practicum; a leadership course and workshop(s); and individual mentoring by a faculty member. In the leadership and mentoring components of the program, students assess and articulate their talents, achievements, and career aspirations; gain experience in team collaboration and leadership; prepare for employment search and interviews; and explore workplace challenges and strategies to meet them. Any Maternal & Child Health concentrator may apply for the Maternal & Child Health Leadership Education Program after completing the first Maternal & Child health core course, MC 725, with a B+ or above and have an overall GPA of at least 3.3.

 

 

5.Describe the health care facilities to cure Tuberculosis available in India.      

ANS   India has a large burden of the world´s TB, one that this developing country can ill afford, with an estimated economic loss of US $43 billion and 100 million lost annually directly due to this disease. Treatment in India is on the rise just as the disease itself is on the rise. To prevent spreading TB, it´s important to get treatment quickly and to follow it through to completion by your doctor. This can stop transmission of the bacteria and the appearance of antibiotic-resistant strains. It is a knowingly fact that bacterial infections require antibiotics for treatment and prevention, thus, commonly you will see that patients diagnosed with tuberculosis have certain pills and antibiotics carried around with them. The antibiotics most commonly used include isoniazidrifampinpyrazinamide, and ethambutol. It is crucial to take your medication as instructed by your doctor, and for the full course of the treatment (months or years). This helps to ward off types of TB bacteria that are antibiotic-resistant, which take longer and are more difficult to treat. In India’s case, the particular type of TB infections are majority resistant to regular antibiotic treatment (MDR-TB, XDR-TB, TDR-TB), therefore, not one or two medications will help, rather a combination of different medications must be taken for over a course of 18–24 months, depending on how deep the infection is. Since the 1960s, two drugs — isoniazid and rifampicin — have been the standard TB treatment. In addition to antibiotics, a vaccine is available to limit the spread of bacteria after TB infection. The vaccine is generally used in countries or communities where the risk of TB infection is greater than 1% each year , thus, the country of India; whose TB infection rate is at a peak (world’s third highest TB infected country), and is consistently growing, and giving 20% of the world’s diagnosed patients a home. At present the anti TB treatment offered in public and private sector in India is not satisfactory and needs to be improved. Today India´s TB control program needs to update itself with the international TB guidelines as well as provide an optimal anti TB treatment to the patients enrolled under it or it will land up being another factor in the genesis of drug resistant tuberculosis.

The Indian government’s Revised National TB Control Programme (RNTCP) started in India during 1997. The program uses the WHO recommended Directly Observed Treatment Short Course (DOTS) strategy to develop ideas and data on TB treatment. This group’s initial objective is to achieve and maintain a TB treatment success rate of at least 85% in India among new patients. “In 2010 the RNTCP made a major policy decision that it would change focus and adopt the concept of Universal Access to quality diagnosis and TB treatment for all TB patients”. By doing so, they extend out a helping hand to all people diagnosed with TB, and in addition, provide better quality services and improve on therapy for these patients.

Treatment recommendations from Udwadia, et al. suggest that patients with TDR-TB only be treated “within the confines of government sanctioned DOTS-Plus Programs to prevent the emergence of this untreatable form of tuberculosis”. As this confirming result of hypothesis is at a conclusion by Udawadai, et al., it is given that the new Indian government program will insist on providing drugs free of charge to TB patients of India, for the first time ever.

 

 

6.Define systematic view of health care.

ANS 

A systematic search was undertaken in PubMed to identify implementation frameworks of innovations in healthcare published from 2004 to May 2013. Additionally, titles and abstracts from Implementation Science journal and references from identified papers were reviewed. The orientation, type, and presence of stages and domains, along with the degree of inclusion and depth of analysis of factors, strategies, and evaluations of implementation of included frameworks were analysed.

A systematic literature search was undertaken to identify all frameworks of implementation of innovations in healthcare published from 2004 to May 2013. A search of literature was conducted using PubMed without language restrictions. The search strategy used was: (“Models, Educational” [MH] OR “Models, Nursing” [MH] OR “Models, Organizational” [MH] OR “Models, Psychological” [MH]) AND (“Diffusion of Innovation” [MH] OR “Organizational Innovation”[MH] OR “Capacity Building” [MH] OR “Decision Making, Organizational” [MH] OR “Organizational Culture” [MH] OR “Information Dissemination” [MH]) AND has abstract AND (model [TIAB] OR models [TIAB] OR theory [TIAB] OR theories [TIAB] OR framework* [TIAB]). In addition, titles and abstracts of all Implementation Science journal articles (Feb 2006 to May 2013) and references from identified papers were reviewed for implementation frameworks.

Inclusion/exclusion criteria

Papers were included if they proposed an implementation framework of an innovation in healthcare. The inclusion criteria were defined as follows (Additional file :

  • Implementationwas defined as the process of putting to use or integrating innovations within a setting. Frameworks needed to include concepts related to the either the stage of ‘operation’ (where the innovation is in use and is in the process of being integrated into routine practice) and/or ‘sustainability’ (the process of maintaining innovation use, capacity and benefits).
  • Frameworkwas defined as a graphical or narrative representation of the key factors, concepts, or variables to explain the phenomenon of implementation, and as a minimum needed to include the steps or strategies for implementation. Papers were included if they proposed a framework, model, or theory of implementation. Eligible papers needed to describe a new, or make change(s) to an existing, implementation framework.
  • Innovation in healthcarewas defined as a novel idea or set of behaviours, routines, and/or ways of working that involve a change in practice within a healthcare setting.

Frameworks were excluded if they were:

  • Focussed on one specific domain, factor, or strategy (for example, organisational context, climate, or behavioural change).
  • Studies applying or validating a framework without proposing a change to the framework.
  • Based on a single case study.
  • Quality improvement frameworks.
  • For the implementation of a culture (for example, safety culture or green culture within an organisation).
  • A model of patient care.
  • To develop the fields of implementation science and knowledge translation (for example, the training of students in implementation).
  • Concentrating on collaborative education as a method for change and models for curricula reform.

Data collection

A single reviewer (JCM) assessed titles and abstracts. For those that appeared to meet the inclusion criteria, the full paper was obtained and assessed. Any papers the reviewer was unsure about were discussed with a second member of the research team (SIB) and agreed upon for inclusion or exclusion.

Data extraction

The literature was critically analysed, by the same reviewer (JCM), to evaluate the frameworks according to the definitions provided and subsequently extract the features from the frameworks:

 

 

7.Describe the cost and quality of care in the private sector.       

ANS  

The private sector project will establish a robust data platform to ensure extensive coverage and comparability across institutions and transitions in patient care settings. This includes transitions in care from acute to rehabilitation and aged care but also between the private and public healthcare systems that can identify areas of cost-shifting and cream-skimming.

The platform will support accurate measurement and assessment of variation in the cost profiles and quality outcomes of different care delivery settings while protecting the identity of each participating facility to ensure high quality information sharing. More detailed perspectives where facilities can be identified will also be available for internal use within private hospital groups.

Sufficient detail will be available to enable operational perspectives of cost and quality performance in the context of the cost profile of each facility reflecting the specific mix of patient services that individual facilities provide.

The platform will expand the ability to analyse and interpret performance to identify areas of cost, inefficiency and poor quality outcomes to allow providers to focus on areas of care that have the greatest potential for improvement.

Fair and appropriate peer comparison and benchmarking will be possible with sufficient detail to see what others are doing that leads to high performance while encouraging shared learning and improvement. Support for flexible approaches to peer grouping will better reflect patient casemix, regional variation and enable hospitals to also form voluntary benchmarking groups and improvement collaboratives on the basis of service mix, patient population and culture.

 

 

8.Describe the delivery of health care services in India.

ANS 

A state of complete physical , mental , and social well-being and not merely the absence of disease or infirmity System :- this is word From late Latin systēma and Ancient Greek ( sustēma , " organised whole, body") example respiratory system. Health care delivery system is initially started from central government of India. The scope of health services is varies widely from country to country and influenced by general and ever changing national, state And local health Problem, need attitude as well as available resources. Health care should be: - Accessible Acceptable Provide scope for community participation Comprehensive Affordable at low cost.

Organization and administration of health services in india at different level. National level State an union territories District health organization and basic specialties hospital/districts Community health sub-districts/ Centers taluka hospital P.H.C Sub centers Village health Guides People in Population. At central level:- Union ministry of health and family The director general of health services The central council of health and family welfare.

At central level:- Union ministry of health and family The director general of health services The central council of health and family welfare. Union ministry function International heath relation and administor of port-quarantine Administration of central health institutes such as “all India institute of hygiene” Promotion of research through research centers and other bodies Regulation and development of medical, nursing and other allied health promotion Establishment and maintains of the drug Census and collection and publication of other statistical data Immigration and migration Regulation of labor in the working in mines. The general function are survey planning, co- ordination, programme and appraisal of all health matters in the country Specific funtion :- international health relation and quarantine control of drug standards medical stores depots post graduation training medical education medical research central govt. health scheme. Environmental hygiene, nutrition, education, promotion, research Making the proposal Distribution sources to the state level Promoting and maintain between central and state level.

Panchayti Raj :- it is rural administration It is last phase in the system of the health care structure Three institution of panchayati Raj are following: - Panchayat :-(at village level) Panchayat Samiti :- (at block level) Zilla parishad :- (at district level)

Panchayat :- Gram sabha :- They meet at least twice in a year and elected the member of gram panchayat gram panchat :- it constitude on the popullation of 5,000 to 15,000 15 to 30 panch as members Headed by surpanch It term upto 3 to 5 year nyaya panchat it villages platform to resolves the disputes between villages /local group Mainting peace among people

Panchayat samiti : - It consist of 100 villages Covering 80,000 to 1 lack people It consist of all surphanchs B.D.O. headed 3) Zilla parishad at the district level collector also member of this team but not right of voting Nearest 70 to 80 members Mainly supervising by collector

Primary health care :- Launched in 1977 base on rural health scheme The principle is “placing people health in people hand” 1983 national health policy based on PHc approved by parliament 1)Village level a) village health guide scheme b) training of local dais c) ICDS scheme( Anganwadi worker) 2)Sub centre 3)P.H.C

Village level one of the basic tends of primary health care. Implement the policy of primary care following scheme are operating:- Village health guides :- a person with an aptitude for social services and it not full time government functionary. This scheme introduced on 2 nd oct 1977 In May 1986 male guide replaced by female health guides They provide the first contact between the individual and the health systems

The guidelines for their selection are :- they should be permanent residents of the local community, preferably women they should be able to read and write having minimum formal education at least 10 th standard Should be accept all section of the community They should be spare at least 2 to 3 hrs every day Training for health guide:- At the PHC Duration 200 hrs for 3 months received stipend Rs. 200/month

 Providing knowledge and training Knowledge is emphasize on elementary concepts of maternal and child health and sterilization The training is 30 working days Stipend of Rs.300 2 days training in a week After completion each dais getting kit and certificate Anganwadi worker One anganwadi for 1000 people popullation Under ICDS

Sub-center level:- it is peripheral outpost of the existing health delivery systems in rural area One sub centre ……. Every 3000 population in hilly and tribal …… Each sub-center one male/female ANM Primary health center level it not new to India before in depended also there was PHC In 1946 Bhore community put the concept of P.H.C. One P.H.C. for 30,000/25,000 One P.H.C. for 20,000/15,000 in hilly and tribal.

Function of P.H.C. M edical care MCH including family planning Safe water supply and basic sanitation Prevention and control of locally endemic disease collection and reporting of vital statistic Education about health National health programme as relevant Referral services Training of health guides health workers local dais and health assistants Basic laboratory services (tubectomy vasectomy and tracheotomy MTP and minor surgery)

Staffing pattern of P.H.C Medical officer 1 Pharmacist 1 Nurse mid-wife 1 Health worker 1 Block extension educator 1 Health assistant 1 Health assistant 1 U.D.C. 1 L.D.C. 1 Lab technician 1 Driver 1 Class VI 4

Job description of members of the health team 1) Medical officer, P.H.C. Captain O.P.D. devotes work at morning Supervised the field at afternoon Supervising and leadership of health team Each month one day participating in meeting at P.H.C. He must to planner, promoter, director supervisor, coordinator and evaluator too.

 Health care female: - Registration:- Pregnant women Married women Number of home visits Care at home:- Care of pregnant women Advice about nutrition and food hygiene Distributes iron & folic acid tab Immunization Finding gynecological problem Family planning

Supervises deliveries First Aid in emergency Notify disease Record and reports of birthdeath Test urine albumin Distribute conventional contraceptive Care at clinic arrange help to M.O. Conduct MCH Family planning clinic at sub centre Care in the community Participant in mahila mandal meeting Helping to other staff other: - maintain cleanliness of centre Attend staff meeting at P.H.C. List the dais of same area Co- ordinating

Health worker male: - Record keeping Malaria (identification, O.P.D. investigation, records, control of spreading, education, followup) Communicable disease Leprosy Tuberculosis Environmental sanitation Expanded programme on immunization Family planning

hospital health centers :- Community health centers: - 31 st march 2003 established by upgrading the primary centers Covering 80,000 to 1.2 lack population 30 beds Specialist surgery C.H.C has provided following services :- Care routine and emergencies cases in surgery Care of routine and emergencies in medicine 24 hrs delivery services Cesareans section Full range of family planning services, laparoscopy too. safe abortion New born care Tracheotomy, nasal pack National health programme Other

Staffing pattern at CHC:- 1) Existing clinical manpower:- General surgeon Physician DGO Pediatrician 2)Proposed clinical manpower:- Anesthetist Eye surgeon Public health manager 3)Existing support manpower:- Nurses + midwifes (7+2) Dresser (certified by Red cross) Pharmacist Lab technician radiographer Ophthalmic assistant Ward boy Sweeper

O.P.D attendent Statistical assistant (date entry, operator ) O.T. attendant registration clerk one ANM and one PHN for family welfare appointed under ASHA

Rural hospital: - It’s convert the sub division hospital into sub division health center. Covering 5 lacks population In this covering P.H.C., sub centre, at tehsil/sub division/ taluka. P.H.C. patient are shifted for infusion level District hospital it’s convert the district hospital into district health centre hospital differs from health centre in the following respect mostly curative services No catchment area Mix team work

Specialist hospital: - The specialist hospital include:- trauma centers Rehabilitation hospital Seniors (geriatric) care Psychiatric hospital Cardiac Oncology etc. Hospital may in a single or number of building on one campus It may expensive or not expensive too. Teaching hospital: - providing clinical education and training to future Provide medical education to the doctor, nsg, health profession In additional providing patient care.

Other agencies health insurance scheme: employee state insurance This act introduce in 1948 The principle of contribution by the employer and employee Provide kind and benefits in the contingency of sickness Maternity care, employment injuries , pension on death on field of work. The act coves employees drawing wages not exceeding Rs. 10,000/month central Govt. health scheme: - Introduced in Delhi in 1954 to provides Provide comprehensive medical care to central govt. employees The facilities under scheme include: - O.P.D. care Supply of necessary drugs Laboratory and x.ray investigation Domiciliary visits hospitalization facilities as well as in private hospital

 Specialist consultation Pediatric services including immunization Antenatal, natal and postnatal services Emergency treatment Supply of optical and dental aids at reasonable rate Family welfare services.

Other agencies :- Defense medical services:- it is largest and almost best organization of health care delivery systems in the country Supported facilities:- Ambulance Mobile beds Hospital (all) Staff ( doctors,nsg,co -workers) Health care of railway employee:- Throughout railway hospital care are provide MCH School health services Specialist unique hospital Primary care Health check-up

 Medical officer are working in sub-division centre The economical sources are providing by railway department for future care at the low cost.

Private agencies:- In a mixed economy such as India´s private practice of medicine a large share of health services available The general practitioner constitute 70% of the medical profession The component of private agencies are poly Nsg home, general practitioner Indigenous systems :- the practitioner of indigenous systems of medicine are ayurveda.sidha,homoepathy 90% of ayurvedic physician serve the rural area The govt. of India is studying best utilized for more effective or total health coverage.

Voluntary health agencies:- Definition:- An organization that is administrated by an autonomous board which holds meeting collects funds for it supported chief from private sources and expanded money. Function: - Supplementing the work of govt agencies Pioneering Education Demonstration Guarding work of govt. agencies Advancing health legislation

Health programme in India:- Since india become free several measure have been undertaken by the national govt. Central govt. for control eradication of communicable disease, improved environmental sanitation etc. India given permission to the foreigner countries to implement them organization in india.

 

 

 

 

Assignment B

Case Detail: 

There is no CASE STUDY answer the following question.

1.What is the role of hospital administrator system? Discuss in detail.

ANS 

Hospital administrators are responsible for the smooth daily operation of their facilities. In that role, they are charged with making wide-ranging decisions about finances, personnel, medical policies, and community relations. Some administrators direct activities for a whole hospital, while others work in individual hospital departments, clinics, public health agencies, rehab facilities, or outpatient care centers. These challenging careers typically require at least a Bachelor’s degree and often a Master’s degree or beyond.

A growing number of undergraduate and graduate level programs in health care administration are available across the country, with options available both online and on traditional campuses. Admission requirements vary widely, but you can expect to take similar types of courses no matter where you study. Every successful administrator will need to be well versed in business management issues, health care policy, and legal and regulatory requirements. Typical business-related classes may include topics such as financial management, data analysis, health care budgeting and accounting, information technology, and health care marketing. On the policy side, you may be required to take classes in American and International health care policy, legal issues in the health care industry, global health systems, and labor relations.

Many schools require you to complete an internship or similar hands-on work experience as a part of a health care administration degree program. Some programs also may require a major project or exam, particularly at the Master’s or Doctoral level of study.

When selecting a college, you will want to consider whether a program has been accredited by a reputable review agency such as the Commission on Accreditation of Healthcare Management Education Association. The Association of University Programs in Health Administration provides certification for these programs and offers a for students who are seeking degrees in the field.

 

 

2.Discuss the role of changing scenario in health care.

ANS 

The health scenario in our country is rapidly changing, both in terms of the public health challenges that we face as well as our response to these challenges. As India becomes more and more developed and we have greater means at our disposal, our response to our health challenges must reflect our changing health and socio-economic status. India faces enormous challenges in the area of women´s and children´s health. India is one of the few countries that have recorded substantial decline in maternal mortality. India is still far from achieving the target set in the millennium development goals. Despite several growth-orientated policies adopted by the government, the widening economic, regional, and gender disparities are posing challenges for the health sector. About 75% of health infrastructure, medical manpower, and other health resources are concentrated in urban areas where 27% of the populations live. To reduce this double burden of diseases, public health has to focus on health promotion, and disease prevention and control, while taking into consideration the social determinant of health. The focus of public health is to bring about change at the policy level not only for preventing disease but also for the health promotion through organized action at societal level.

 

 

3.Discuss International Health Governance in detail.  Solve by www.solvezone.in

ANS  

International Institutions and Global Governance program, examines the complicated landscape of global health governance, assesses the capabilities of existing institutions, and recommends more effective strategies for policy implementation. Although the United States will not have the resources to contribute to global health at the same level as it did over the past two decades, the paper argues that U.S. leadership will be critical to future success in global health governance.

hree crises in 2009 revealed the inadequacy of global health governance. The outbreak of pandemic influenza A (H1N1) found countries scrambling for access to vaccines, an unseemly process that led the World Health Organization to call for a new "global framework" on equitable influenza vaccine access. The global economic crisis damaged efforts to achieve the Millennium Development Goals, most of which involve health problems or address policy areas affecting health. The year ended with the fractious Copenhagen negotiations on global climate change, a problem with fearsome portents for global health.

Unfortunately, concerns about global health governance are not limited to these epidemiological, economic, and environmental crises. Experts also warned about issues: the failure to prevent HIV/AIDS, antimicrobial resistance, counterfeit drugs, the global prevalence of no communicable diseases related to tobacco consumption and obesity, the migration of health workers from developing to developed countries, and the deterioration in the social determinants of health. Efforts to address these and other global health problems often acknowledge that existing institutions, rules, and processes are insufficient to support collective action.

The United States will influence how cooperation on health unfolds in the twenty-first century. It provided leadership in the global health governance revolution through expanded foreign assistance, bilateral engagements, regional initiatives, and participation in multilateral organizations. However, without more effective strategies and better policy implementation, the U.S. role in the next phase of global health governance will diminish under the pressures of competing priorities and shrinking financial resources. To provide leadership over the course of the next decade, the United States should take the following steps to improve global health governance:

– Craft a comprehensive global health strategy for the U.S. government;

– Focus on priority areas of global health governance, namely the International Health Regulations 2005 (IHR 2005), global tobacco control, the Millennium Development Goals, and strengthening national health systems in developing countries;

– Embed global health as a priority for the Group of 20 (G20) by creating demand for global health issues on its agenda;

– Strengthen health cooperation within regional organizations; and

– Integrate health inputs into debates about global governance problems outside the health realm, such as economic governance, trade, and climate change.

 

 

 

 

Assignment C

Question No.  1           Marks - 10

Which care has become one of India´s largest sectors - both in terms of revenue and employment?

 Options           

  1. Health
  2. Finance
  3. Agricultural
  4. Medicine

 

Question No.  2           Marks - 10

According to National Family Health Survey-3, the private medical sector remains the primary source of health care for ------- of households in urban areas. 

 Options          

  1. 60%
  2. 80%
  3. 70%
  4. 50%

 

Question No.  3           Marks - 10

The --------- sector has emerged as a vibrant force in India´s healthcare industry.

 Options          

  1. Public
  2. Private
  3. Modern
  4. Specialized

 

Question No.  4           Marks - 10

Which healthcare sector is responsible for the majority of healthcare in India? 

Options          

  1. Modern
  2. Public
  3. Private
  4. Specialized

 

Question No.  5           Marks - 10

Which would provide universal health coverage throughout India?              

Options          

  1. Strivers
  2. Makers
  3. Believers
  4. Plans

 

Question No.  6           Marks - 10

International health, also called geographic medicine or --------- health is a field of health care. 

Options          

  1. Global
  2. Regional
  3. State
  4. State

 

Question No.  7           Marks - 10

The International Health Regulations (IHR) is an international legal instrument that is binding on -------countries across the globe. 

Options          

  1. 198
  2. 196
  3. 178
  4. 176

 

Question No.  8           Marks - 10

In which Country cholera epidemics hit, in 1830 and 1847 made apparent the need for international cooperation in public health. 

Options          

  1. India
  2. Europe
  3. England
  4. France

 

Question No.  9           Marks - 10

Who divided International health organizations into three groups: multilateral organizations, bilateral organizations, and non-governmental organizations (NGOs).

 Options          

  1. MGO
  2. KPO
  3. NGO
  4. WHO

 

Question No.  10         Marks - 10

An international society committed to improving global health – particularly regarding ------------- diagnosis, treatment and control. 

Options           

  1. Physical Health
  2. Mental Health
  3. Tuberculosis
  4. Dental

 

Question No.  11         Marks - 10

A --------- hospital typically is the major health care facility in its region.     

 Options          

  1. District
  2. Private
  3. Public
  4. Specialized

 

Question No.  12         Marks - 10

Who visited India during the time of Chandagupta and provides us details about the charitable dispensaries in Pataliputra. 

 Options          

  1. Romein
  2. Fa-hien
  3. Hiuen
  4. Chein

 

Question No.  13         Marks - 10

Caraka-samhita is a classical book of ------------system of medicine.

 Options          

  1. Unani
  2. Ayurvedic
  3. Siddha
  4. Indian

 

Question No.  14         Marks - 10

Which hygiene is the science and practice of the recognition, treatment, and prevention of oral diseases?

 Options          

  1. Eye
  2. Ear
  3. Mental
  4. Dental

 

Question No.  15         Marks - 10

In which year, Ferlie and Shortell, divided the health care system is into four “nested” levels.

 Options          

  1. 2003
  2. 2002
  3. 2001
  4. 2004

 

Question No.  16         Marks - 10

Malaria is probably one of the --------- diseases known to mankind.

 Options          

  1. Oldest
  2. New
  3. Ancient
  4. Modern

 

Question No.  17         Marks - 10

According to National AIDS Control Organization of India, the prevalence of AIDS in India in ------------- was 0.27. 

 Options          

  1. 2011
  2. 2013
  3. 2012
  4. 2010

 

Question No.  18         Marks - 10

In which year the Government of India launched the National Mental Health Program (NMHP)?

 Options          

  1. 1983
  2. 1982
  3. 1985
  4. 1986

 

Question No.  19         Marks - 10

The vast majority of ------infections in India occur through sexual transmission.     

 Options          

  1. Mental
  2. HIV
  3. Fungal
  4. Bacterial

 

Question No.  20         Marks - 10

Tuberculosis (TB) is an infectious disease caused by a Bacterium, -----------------tuberculosis.

 Options          

  1. Salmonella
  2. Staphylococcus
  3. Mycobacterium
  4. Escherichia

 

Question No.  21         Marks - 10

Which of the following determinants of health is a ´downstream´ determinant?      

 Options          

  1. Housing
  2. Employment conditions
  3. Age
  4. Education

 

Question No.  22         Marks - 10

In a population of 10,000,000 people, at a given time 500 individuals have motor neurone disease. What is the point prevalence of motor neurone disease in this population at this given time?     

 Options          

  1. 05 per 100,000
  2. 5 per 100,000
  3. 5 per 100,000
  4. 50 per 100,000

 

Question No.  23         Marks - 10

Which of the following is not commonly considered to be part of the public health function of community pharmacists?  &nb

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