California State University, Chico

DEPARTMENT OF HEALTH AND COMMUNITY SERVICES

HCSV 431 (formerly HCSV 231)

Fall 2005

THE HEALTHCARE DELIVERY SYSTEM

Butte 229

Tuesday, 6:00 to 8:50

Richard A. Narad, D.P.A.

Phone:  (530) 898-5309

Butte 627

FAX: (530) 898-5107

Email: RNARAD@CSUCHICO.EDU

Office Hours:  Monday 10:00 to 12:00, Tuesday 2:00 to 5:00, or by appointment

1.      Scope of Course:  This course will provide an overview of the healthcare delivery system in the United States as it responds to the range and extent of healthcare needs.  We will discuss: 1) the major components of the system and the roles and responsibilities of system participants, 2) the differences among health financing mechanisms and issues relating to healthcare cost containment, including market failures in healthcare, and 3) current issues in the healthcare delivery system.

2.      Learning objectives:  This course helps to meet the following objectives of the B.S., Health Science, Option in Health Services Administration:

The graduate in Health Services Administration will have knowledge, skills, and beliefs related to the health care delivery system and will identify participants in the system and describe their roles, responsibilities, and trends and issues related to them.

 

  • Identify various system participants.

Midterm and final exams

  • Analyze a career within a specific type of health services organization or health subsystem.

Healthcare organization paper

  • Describe some aspect of the healthcare delivery system.

Topic paper

  • Compare some aspect of the U.S. healthcare delivery system to that in another country..

Comparative health paper

 

 

The graduate in Health Services Administration will have competent communication skills, including written and spoken communication, use of electronic media, and formal presentations/business reports

 

  • Develop a variety of communication skills

Papers and presentations

  • Search websites

Use class webpage and email lists.

 

The complete objectives of the B.S. Health Science with an option in Health Services Administration are available at http://www.csuchico.edu/hcsv/hsa_obj.html

3.      Reading Materials:

Texts:

  • Anthony R. Kovner and James R. Knickman (eds.) Health Care Delivery in the United States, 8th ed. (New York: Springer Publishing Co., 2005).

Health administration core library:

  • Vergil Slee, Debora Slee, & HJ Schmidt (eds.) Slee's Health Care Terms, 4th Edition (St. Paul, MN: Tringa Press, 2001).

  • Diana Hacker A Pocket Style Manual, 4th ed. (Boston: Bedford Books of St. Martin’s Press, 2004)

Articles on WebCt:

  • Richard NARAD "EMS System Design" Emergency Clinics of North America (1990)

  • John E. KRALEWSKI, et al.  “The Organizational structure of medical group practices in a managed care environment” Health Care Management Review (1998)

Other (free subscription required)

  • Kaiser Daily Health Policy Report

  • California Healthline

4.      Course Format:  Classes will combine lectures, discussions, guest speakers, and student presentations.

5.      Grading:

 

Exams

 

  • Midterm....................................................................................................... 200

 

  • Final............................................................................................................. 200

 

Projects

 

  • Topic paper and presentation.................................................................. 200

 

  • Healthcare organization paper and presentation................................... 200

 

  • Comparative systems paper and presentation...................................... 200

 

Other

 

  • Attendance:  50 points lost for every session missed.  One excused absence will be allowed.

 

  • Everyone will do three papers, but only two presentations.  Everyone will present their Topic Paper and either their Healthcare organization paper or their Comparative paper.  Presentations are worth 25% of the total points for the assignment.

 

  • The  subject description and identification of sources for the Healthcare organization paper and Comparative systems paper will be graded as acceptable or unacceptable.  Any unacceptable material must be redone or the final paper will not be accepted. 

 

  • Late written assignments will be eligible for one-half credit, if received within one week of the due date.  No assignments will be accepted after one-week and no late presentations will be allowed.

 

Grades:

 

 

A            930 - 1000

C+       770 - 799

 

A-           900 - 929

C         730 - 769

 

B+          870 - 899

C-        700 - 729

 

B            830 - 869

D+       660 - 699

 

B-           800 - 829

D         600 - 659

 

6.      Projects and Activities:

 

  • Topic paper: Paper and presentation on a topic listed in the course outline.

 

  • Healthcare organization paper: Paper and presentation on a type of healthcare organization.

 

  • Comparative systems paper: Paper and presentation comparing an aspect of the United States’ healthcare delivery system with that of another countries.

 

  • Readings: Students are expected to have read the assigned readings by the date indicated on the course schedule.

 

  • Class participation: Attendance is expected.  Participation means more than being present in class.  Students are expected to actively participate in class activities and discussions.

 

  • Standard:  This syllabus includes descriptions of each of the written assignments.  General standards are described below.  Students should ensure that papers and presentations include all of the required items and meet these standards.

 

7.      Confidentiality:  During this course, the instructor, guest speakers, or students may share information regarding specific organizations or individuals.  Such information should be treated as confidential and not discussed outside of the classroom.  If you are in doubt regarding the confidentiality of any information, consult the instructor.

 

8.    Academic honesty: Students must ensure that appropriate credit is given for all materials.  Ideas taken from other persons must be properly cited.  Any direct quote must be enclosed in quotation marks and must be cited.
 
All papers will be checked for plagiarism at "turnitin.com".  Any student who engages in academic dishonestly (e.g., plagiarism, cheating, etc.) will receive a failing grade in this course and Student Judicial Affairs will be notified. 

 

9.      You should be aware that this class will be harder than most classes that you have taken.  Assignments should be of the same quality that is expected of an employee in a professional position in the healthcare field.  That means that grammar and spelling will be considered in grading assignments.  It means that due dates and project specifications are taken seriously.  It means that attendance is expected.

 

10.    Written papers:  All papers turned in for this course must comply with the following:

 

  • You must turn in both a hardcopy (printed) version of your term paper (which I will grade and return to you) and an electronic version.  The electronic version must be PC compatible and formatted as a Text (*.txt), MS-Word (*.doc), or Rich-Text-Format (*.rtf) file.  It should be send via WebCT’s email as an attachment.  Papers will be checked for plagiarism at "turnitin.com".

 

  • Use 81/2" x 11" paper, with one-inch margins on all sides

 

  • Type all written materials, with all text, including quotes, double-spaced

 

  • Do not use covers or cover pages

 

  •  Use a readable font with 10 characters to the inch.  NOTE:  This is not 10 pitch.  (Courier works.  Times New Roman does not).  For other fonts, if you aren’t sure, take a ruler, measure one inch and count the number of characters. 

 

  • Do not exceed the maximum length for the assignment.

 

  • Papers must be free of typographical and spelling errors and must be grammatically correct.

 

  • Papers not meeting these standards may be returned for rewriting before they are graded.  Any rewrite will result in a reduction of one grade.

 

11.    Presentations:  The presentation that you make in this class must comply with the following:

 

  • Presentations should cover the same area as the paper, but should not be just a reading of the written paper.  DON’T READ YOUR PAPER!

 

  • Be prepared to respond to questions from the instructor and the class

 

  • Do not exceed the maximum time for the presentation.

 

  • Use visual aids (e.g., PowerPoint, overheads, presentation graphics) and handouts, in an appropriate manner.

 

  • PowerPoint will be available when the career and comparative health presentations are scheduled.  If you want to use it for your topic paper, let the instructor know the previous week.

 

  • Dress professionally.  This means the same way that you would dress for a job interview or a professional presentation.

 

12.    On-line resources:  This class requires the use of WebCT.  I will place class handouts on the site prior to each week's class.  Other materials (including old exams) and relevant linkages can be found there.

 

 

 

 

Course Schedule and Assignments

K/K = Kovner and Knickman

 

 

 

 

Session/Week

Topic(s)

Assignments

1 (8/22)

Introduction

Health system overview

 

2 (8/29)

Resources

Development of the healthcare delivery system

K/K chapters 1, 2, Appendices B and C

3 (9/5)

Acute care hospitals

K/K chapter 7

Healthcare organization paper subject

4 (9/12)

Health personnel

Physicians

K/K chapter 12, 14

5 (9/19)

Physician practice settings

Nurses

K/K chapter

6 (9/26)

Non-MD providers

Allied health professions

Pharmaceuticals

K/K chapter 11

Kralewski

7 (10/3)

Healthcare subsystems:

  • Long-term care

  • Mental health

  • Emergency medical services

K/K chapters 8, 9; Narad

Healthcare organization papers and presentations

 

8 (10/10)

MIDTERM

9 (10/17)

Utilization of health services

        

K/K chapter

Healthcare organization presentations

Comparative systems paper subject

10 (10/22)

Health economics

K/K chapter 3

11 (10/31)

Payers and managed care organizations

12 (11/7)

Medical legal issues

Healthcare issues and reform proposals

K/K chapters 5, 15, 16, 17

13 (11/14)

 NO CLASSES DURING WEEK OF NOVEMBER 21st

14 (11/28)

Comparative health systems

  • Germany, Canada

 

K/K chapter 6

Comparative systems papers and presentations

15 (12/5)

Comparative health systems

  • Britain, Sweden

Future of h/c delivery

K/K chapter 18

Comparative systems presentations

16 (12/12)

FINAL EXAM (Time to be announced)

 

 

 

TOPIC PAPER AND PRESENTATION

Assignment:  Select a topic area from this syllabus and develop a short paper and a brief presentation.  Sign up for your topic during the second class session.  Presentations will be incorporated into the appropriate class session.  You should discuss your paper with the instructor at least two weeks prior to the scheduled presentation.

 

Content:  A topic paper/presentation is not intended to be a mechanical report on books and articles read.  Instead, it is an essay where key issues and themes are uncovered and integrated by the student.  The paper and presentation may (as appropriate) include:

1.  Brief history

2.  Description

3.  Purpose/role in healthcare delivery system

4.  Trends/controversies

Papers will be a maximum of three pages (plus endnotes).  This means that only the major themes can be included.  This usually involves writing several drafts in order to boil the concepts and discussion down to a brief essay.  Presentations will be a maximum of five minutes.

 

HEALTH ORGANIZATION PAPER

Assignment: Select a type of organization (e.g., skilled nursing facility, group practice, ambulance service) found in the healthcare delivery system and .  Be as specific as possible—e.g., not just “a health facility.”  This assignment is intended to allow you to explore an area of the healthcare delivery system which you are (or might) be considering for a career.  It provides you with an opportunity to increase knowledge about this area, including the available literature in this area. 

Subject:  A brief description of your subject is due early in the semester.  This should include

 

Content:  The paper should include:

1.      General description and purpose

2.      Services provided

3.      Clients/patients/customers

4.      Ownership (e.g., public/private, for-profit/not-for-profit, mixed)

5.      Types of personnel and facilities used

6.      Relationships with other healthcare organizations

7.      Funding

8.      Trends and issues

Papers will be a maximum of three pages (plus endnotes).  Attach the outline, with my approval on it.
 

COMPARATIVE HEALTH SYSTEMS PAPER

Assignment:. Select an area of interest from anywhere in the healthcare delivery system.  Compare it between the U.S. and one other country’s health care system.  You may focus on a:

Subject/Outline:  A brief description of your subject is due early in the semester.  This should include

Content:  The paper should include:

 

For healthcare delivery subsystems:

1.      Overview of the other country’s healthcare system;

2.      General description and role of the subsystem, including relation with other parts of the health system (as appropriate), types of organizations and personnel found in this sector (as appropriate), funding sources, and trends and issues;

3.      Comparisons and contrast with the equivalent subsystem in the U.S;

4.      Pros/cons of each countries’ approach;

5.      Lessons for the U.S. and your recommendations.

 

For health policy issues:

1.      Overview of the other country’s healthcare system;

2.      Summary of the issue, including current status, trends and issues, and potential policy options;

3.      Comparisons and contrast with the equivalent issue in the U.S;

4.      Pros/cons of each countries’ approach;

5.      Lessons for the U.S and your recommendations.

Do not take the whole paper to describe the systems/issues.  Instead, at least one-third of the paper should be used to analyze, including your view of the pros/cons of each countries’ approach, lessons for the U.S., and your recommendations

Papers will be a maximum of three pages (plus endnotes).  Attach the outline, with my approval on it.