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2. 3. 4. 5. E. MarketH. Micro-Economic AppraisalH. Micro-Economic AppraisalAnalysisB. What influencesB. What influences A. What is Health? A. What is Health?Health? (other Health? (otherWhat is its value? What is its value? thanthanhealth care)health care) C. Demand for C. Demand forD. Supply ofD. Supply ofHealth CareHealth Care Health CareHealth Care F. Macro- F. Macro-G. Planning, budgeting,G. Planning, budgeting, Economic Economicregulation mechanismsregulation mechanisms Appraisal Appraisal 6. , , 7. 8. PRICE 08 A . 06B 003005 QUANTITY 9. PRICE 08 A . 06 . B 003005 QUANTITY, 10. PRICE Conflicts between Supplier and Consumer 06 005 QUANTITY 11. PRICE , 08 A 06 B 003 005 QUANTITY 12. 13. .... Health Economic 14. ..health datahealth expenditure l public, % of total health expenditure.xls ..health datahealth expenditure total % of GDP.xls 15. : ..... 16. 17. ... 18. , . : , 19. ((EFFICIENCY , = / 20. 21. . . : 22. ) (JCAH" health care quality is getting the right care to the right patient .at the right timeevery time 23. ...... ..... . ... 24. : ...( ) ..... ( ) .... 25. ... 26. 27. 28. . 29. 30. : 31. 32. 1. 2. 3. 33. 1. 2. 3. 4. 34. : . , . 35. ( ) 36. ( ) 37. 1. 2. 38. 2. ....... . . . . 39. 3. . . 40. 4. : : : : . !! , . 41. 42. 43. ....... + = 44. 45. 46. 1. 2. : 47. 48. 49. : , , : , , , , 50. : 21 51. : . ( ) : 52. ( ) : : ( ) 53. 1. : + 2. 3. : : 4. : ( ) :1. , 54. : . : , , , , , . 55. Input output 56. input Out put 57. 1. 2. , 58. 3. : ( ) 03 07% 03% . 59. : 60. 61. ( ) 62. ( ) 63. , . . 64. 65. 1. 2. 3. 66. , .... . 67. 68. 69. , 70. 71. 72. , 5% 01%, % 5% . . 02% 01% , , , 06% 2% 73. : . 74. , , , , , , 75. , , , . 76. , 77. , 78. 79. 80. , , , 81. 82. 83. 1 2 84. 85. 86. Medical care as an output ofthe medical servicesindustry & as an input to health , : , 87. 88. , . . 89. 90. . . 91. . ( ) 92. , ( 0102) 93. ( ) 94. ( * ) 95. : : : , : 96. 97. , : , , , . , 98. 06 % , , 57% 99. GDP The gross domestic product (GDP) is one theprimary indicators used to gauge the health of acountrys economyis the market value of all officially recognized final goodsand services produced within a country in a given periodof time. GDP per capita often considered an indicator of acountrys standard livingGDP per capita is not a measure of personal income Undereconomic theory, GDP per capita exactly equals the grossdomestic income (GDI) per capita 100. Average Bed Occupancy Rate inMENA region Relative to the OECD Average 90%80%80% 80%72% 70% 65% 65% 64%60%58% 56% 60%54% 53% 52% 50%45% 40%37% 30% 20% 10% 0% ainananaan iaon E co iapt D tbi es i Aisrar erCrd gy oc m Iranra SylU un E Palgah OorE Joeb AO AT B M L i ud SaSource: World Bank, 2005 101. Total Health Expenditures asPercentage of GDP in MENA CountriesKuwait 2.2 Oman2.5United Arab Emirates 2.6Saudi Arabia 3.4Bahrain3.8Qatar4.1Syria4.2Yemen, Republic5.1 Morocco5.3Tunisia5.5Iran, Islamic Republic 6Egypt6.1Djibouti 6.9 Lebanon 8.7Jordan10.5 0 2 4 6 8 1012 102. Health Expenditure as % of GDP1210 8 OECD 6 UK 4 Germany 2 01980 2000 2002 2004 2006OECD 2009 103. Public spending on Health as a Share of GDP Declining TrendsPublic spending on health trend in GCC4 3.5Bahrain% of GDP3Kuwait 2.5OmanQatar2SA 1.5UA2001 2002200320042005 year Source: WHO NHA Estimates 104. Government Health Spending as a %of Total Government Spending 14.3Lebanon11.9 10Qatar 9.79.5 Jordan 9.59.2 UAE8.88.7Egypt 7.36.8 Tunisia6.56.5 Kuwait 6.26.1 Yemen5.65.5Iraq 3.4 0 2 4 68 10121416 Source: WHO 2009 NHA Estimates for 2005 105. Out of Pocket Spending as a Share ofTotal Health Spending in MENA Updated NHA Data 2005 Saudi Arabia3.9OmanQatarKuwait21UAE Bahrain DjiboutiIraqLibya JordanIranLebanonTunisiaMorroco Syria YemenEgypt 61 0 10203040 50 6070Source: WHO 2009 NHA Estimates for 2005 106. Life Expectancy from Birth in GCC,MENA and OECD Countries, 2006 OECDMENA GCCDjiboutIraqYemenEgyptMorrocIran JordanAlgeriaLebano Syria SaudiT unisiaLibyaQat arOmanBahrain Kuwait UAE 0 20 4060 80 100Life Expectancy from Birth Source: WHO Statistical Database, 2009 107. Prevalence of Obesity Among Adults > 15 years5045403530Males25Females201510 5 Kuwait 0Children < 5 years JapanGermany AustraliaBahrain Kuw ait SaudiUAE ArabiaSource: Christian Gericke: WHOSIS data 2007 108. , , ( , ), , . ( 2) 109. : 110. : , : * 005.0 * 005.0 997.0 * 008.0 111. 112. 113. ( ) : 114. , , . 115. , 116. : 117. 1. 2. 3. : 118. 1. , , .2. , , 119. 3. , , .4. , 120. 121. 1. , .2. 122. 3. 4. 123. .. 124. ,BSC 2991, 125. 6991 126. A MeasurementSystem?A Management System? A ManagementPhilosophy? 127. 128. If you fail to plan, you plan to fail 129. : : ( ) 130. : :* * , 131. , , , , , , ... . 132. , 133. , , , 134. The Mission"If we succeed, how will weTo achieve our vision, how mustlook to our financial donors? we look to our customers? To satisfy our customers, financial donors and mission, what business processes must we excel at?"To achieve our vision, how must our people learn, communicate, and work together?The Mission, rather than the financial / shareholder objectives,drives the organizations strategy 135. BSC Change The Revenue Growth Strategy Improve stability by broadeni ng the sources of revenue from IncreaseCustomerConfidenc eOurinFinanci alAdvicecurrent customers Broaden Revenue MixImprove Returns ImproveOperatingEfficiency The Productivity Strategy Improve operating efficienc y by s hifting customers to more cost- Increase CustomerSatisfaction Through Superi orExecution effective channels of distributionFinancialPerspective CustomerPerspectiveInternalPerspectiveFormulate and communicate a new strategy for aUnderstand DevelopCross-Sel lShiftto ProvideMini mize CustomerNewtheProduct AppropriateRapidProblems SegmentsProducts LineChannelResponseIncrease EmployeeProductivity Learning Perspective DevelopAccesstoAlignStrategicStrategic Personalmore competitive environmentSkills Information GoalsGrowthIncrease revenues, not just cut costs andenhance productivityImplementFrom the 10 to the 10,000. Every employeeimplements the new growth strategy intheir day-to-day operations 136. BSC 137. (41) (1) (61) (9) (6) 03% (4) (5) (3) 09% (8) (01) (2) 03% (21) () (9) (11) (7) 5% (51) (31) , 05% 138. 1: 831 5% 52% 58% 06% Introduction to Strategy Maps By KMB 139. The Vision BarrierOnly 5% of the work forceunderstands the strategy The People BarrierThe Management Barrier 9 of 10 85% of executive teams spendOnly 25% of managers havecompanies fail less than one hour per monthincentives linked to strategyto executediscussing strategystrategy60% of organizations dont link budgets to strategy The Resource Barrier Todays Management Systems Were Designed to Meet The Needs of Stable Industrial Organizations That Were Changing Incrementally You Cant Manage Strategy With a System Designed for Tactics 140. Balanced Scorecard Early Adaptors Have Executed Their Strategies Reliably and RapidlyMobil1993 #6 inprofitability19951996 #1 in profitability #1 in profitability(USM&R) 1997 #1 in profitability Profit Stock $275M loss 1994 $15M$74 1993 1995 $60M $114Stock Price = $59 1996 $80M $146Property & Casualty1997 $98M $205#1 in growthBrown & RootLosing 1993 1996 and Engineeringmoneyprofitability (Rockwater)1994 Profits = $8x 1993 Profits = $x1995 Profits = $13x Retail Bank1996 Profits = $19x 141. Chronic Disease Self-Management Program : : Self management Support 142. Chronic Disease Self-Management ProgramGoalThe active participation by people in their own healthcare within their communities.VisionPeople with chronic conditions are supported in their ability to respond to their health care needs through Self-management approach, by making informed choices in partnership with health providers to optimize their desired lifestyle 143. Chronic Disease Self-Management ProgramThe term self-management refers to the tasks thatan individual must undertake to live well with oneor more chronic conditions. These tasks include havingthe confidence to deal with medical management,role management, and emotional management of theirconditions 144. Chronic Disease Self-Management ProgramSelf-management is both an outcomeand a process.As an outcome, self-managementmeans the positive behaviors thatpatients carry out, such as eating right,exercising, monitoring symptoms,taking medications, and knowingwhen to seek professional help 145. Chronic Disease Self-Management ProgramThe process of self-managementinvolves the actions people followto make and sustain their behavioralchangesThis includes steps such assetting goalsdeveloping action plansdeciding how they might overcomebarriers, and monitoring theirprogress in meeting their goals 146. Chronic Disease Self-Management ProgramWhy is self-management supportimportant?Many patients with chronic conditionswill need both patient education andself-management support.Research with diabetes patients hasshown that augmenting a traditionalpatient education program with addedelements of self-management supportcan improve health outcomes 147. Chronic Disease Self-Management ProgramWho is involved in self-managementsupport?Successful self-management dependson a partnershipbetween patients and health careproviders within a supportive healthcare system gps 148. Chronic Disease Self-Management Programpatients and families affected by chronic diseaseprimary health care providers, including doctors,nursessocial workers, pharmacists, and otherprofessionals, as well as lay community healthworkers who may also deliver self-managementsupport, particularly in remote communities; and health system managers and policy-makers 149. Chronic Disease Self-Management Program , 150. Chronic Disease Self-Management Program : 151. Chronic Disease Self-Management Program 01 03.2 3 1 + 1 3 152. Chronic Disease Self-Management Program Subjects that participated in program, compared tothose that did not, demonstrated significantimprovements in : exercise, cognitive symptom management communication with physicians, self-reportedgeneral health health distress, fatigue, disability, and social/roleactivities limitations - See more at 153. It helped me change my attitude towards aspects of my condition. Through using action plans, I took small steps to start exercising. I realized I was not the only one who experienced the inability to cope. Im still frustrated with life, but have learnt ways to deal with the frustration 154. I lacked motivation at the beginning of the [self- management] course, but I am definitely more motivated now. I was reminded how to problem- solve and became more aware of the chronic cycle. I feel I have improved my own wellbeing, health and self-esteem 155. Approximately half of all Canadians are living with atleast one chronic health condition, and more than one in four Canadians report having twoor more chronic conditions Many will live well and long despite having a long-term health concern, but others will not Chronic disease costs Canadian society more than $90 billion a year in lost productivity and healthcare costs 156. 157.