California State University, Chico

DEPARTMENT OF HEALTH AND COMMUNITY SERVICES

HCSV 431-Section 2

Fall 2009

THE HEALTHCARE DELIVERY SYSTEM

Butte 229

Tuesday/Thursday 33:0 to 4:45

Richard A. Narad, D.P.A., J.D.

Phone: (530) 898-5309

Butte 627

FAX: (530) 898-5107

Email: RNARAD@CSUCHICO.EDU

Office Hours: Tuesday/Thursday 1:00 to 3:30, 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.

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

· Describe some aspect of the healthcare delivery system.

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

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

· Search websites

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:

· Leiyu Shi & Douglas A. Singh. Delivering Health Care in America: A Systems Approach, 4th Ed. (Jones and Bartlett, 2008).

Health administration core library:

· Vergil Slee, Debora Slee, & HJ Schmidt (eds.). Slee's Health Care Terms, 5th Edition (St. Paul, MN: Tringa Press, 2008)—earlier editions are acceptable.

· Diana Hacker. A Pocket Style Manual, 5th ed. (Boston: Bedford Books of St. Martin’s Press, 2008)—earlier editions are acceptable.

Articles on WebCt Vista:

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

· Dan Beckham. “Integration versus Independence” Health and Hospitals Network Weekly

· Atul Gawande. “The Cost Conundrum: What a Texas town can teach us about health care” The New Yorker (June 1, 2009 )

· Texas Medical Association. “Border Health Caucus Response to The New Yorker Article The Cost Conundrum”

Other (free subscription required)

· Kaiser Daily Health Policy Report

· California Healthline

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

5. Grading:

Exams

· Final.............................................................................................................

250

Projects

· Healthcare personnel paper............................................

250

· Hospital profile paper…………….....................................

250

· Comparative systems paper...................................... ….

250

Subtractions

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

· Reading quizzes: Up to five reading quizzes will be given during the semester. Failure to pass the quiz will result in 25 points being deducted from your total grade, but no additional points will be added.

Other

· The subject description and identification of sources for the 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.

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:
· Healthcare personnel paper: Paper on a category of healthcare personnel.
· Comparative systems paper: Paper 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 include all of the required items and meet these standards.
· If you have difficulty writing, the Writing Center (898-5042, Student Services Building 310) on campus provides free tutoring and help with specific papers. USE THEIR SERVICES.
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. 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). You must also submit an electronic version to "turnitin.com" using the link available on the class WebCT Vista page.
· 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. On-line resources: This class requires the use of WebCT Vista. 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.

S&S = Shi & Singh

Week	Monday	Topic(s)	Assignments
1	8/24	Introduction Health system overview
2	8/31	Resources Development of the healthcare delivery system	S&S 1 (except pp. 21-28), Ch. 3 *Personnel paper signups*
3	9/7	Tuesday, 9/8—Furlough day
3	9/7	Thursday, 9/10—Furlough day
4	9/14	Acute care hospitals	S&S Ch. 8
5	9/21	Health personnel Physicians	S&S pp. 119-137; Beckham
6	9/28	Physicians (cont) Physician practice settings	S&S Ch. 7
7	10/5	Nurses Allied health professions Non-MD independent practitioners	S&S pp. 137-151 *Healthcare personnel papers*
8	10/12	Tuesday, 10/13—Furlough day
8	10/12	Thursday, 10/15: Furlough day
9	10/19	Healthcare subsystems: · Long-term care · Mental health	S&S Ch. 10, 11
10	10/26	Healthcare subsystems (cont): · Emergency medical services · Pharmaceuticals	S&S Ch. 5; Narad
11	11/2	Utilization of health services	Gawande; Texas Medical Association *Comparative systems paper subject*
12	11/9	Health economics
13	11/16	Payers and managed care organizations	S&S Ch. 6, 9
		NO CLASSES DURING WEEK OF NOVEMBER 24^th
14	11/30	Healthcare issues and reform	S&S Ch. 2, 12, 13
15	12/7	Comparative health systems Future of h/c delivery	*Comparative systems papers* S&S pp. 21-28, Ch. 14
16	12/14	FINAL EXAM (Time to be announced)

NOTE: Schedule is subject to change

HEALTHCARE PERSONNEL PAPER

Assignment: Select a category of health care personnel. Sign up from a list provided in class.

Content: The paper should include:

1. General description and role

2. Services provided

3. Work setting(s)

4. Salaries

5. Career ladder

6. Training/education

7. Licensure/certification

Papers will be a maximum of three pages (plus endnotes). Your sources should include an interview with someone in this profession.

HOSPITAL PROFILE

Assignment: Select a California hospital (we will do sign-ups in class). Using the data sources provided on WebCT Vista, create a profile of the hospital

Content:

1. Complete the hospital profile form (available on WebCT Vista).

2. Summarize the data.

For each data point, show the source of the information (list as “A”, “B”, etc.).

In addition to the form, the summary should be one page.

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:

Healthcare delivery subsystem (e.g., acute care, long-term care), or
Policy issue (e.g. funding, rationing).

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

A 2-3 sentence statement of the subject, the country that you will use for your comparison, and your reason for selecting the subject and country;
The citations for at least three references from professional sources which you will use for your paper.

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).