Lecture 1
Readings:
● Book chapters 1, 2, 3, 8
● Kaissi (2012)
● Wiersinga & Levi (2016)
● Pfeffer & Sutton (2006)
● Rousseau (2006)
Course objectives:
1. Explain why healthcare management exists as a distinctive discipline within management.
2. Understand the systematic challenges healthcare management is facing.
3. Discuss the major defining components of healthcare systems.
4. Outline effective strategies for working with healthcare professionals.
5. Reflect on the relevance of basic management accounting functions in healthcare settings.
6. Argue against which kinds of standards healthcare quality can be evaluated.
Course outline:
● Lectures on mondays
● Tutorials on thursdays
● Podcasts to accompany lectures
● Assignments: 3, during tutorials
Health = A state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity (WHO, 1984)
Health = The ability to adapt and to self-manage, in the face of social, mental and physical challenges of
life (Huber, 2011).k
, 6 factors of health
(BDM, MQP):
● Bodily
functions
● Mental well-
being
● Meaningfulness
● Quality of life
● Participation
● Daily functioning
Lemmen, C. H., Yaron, G., Gifford, R., & Spreeuwenberg, M. D. (2021). Positive Health and the happy
professional: a qualitative case study. BMC family practice, 22(1), 1-12.
Quadruple aim of healthcare (SIRS):
,Management makes a difference in healthcare management.
Challenges for healthcare management:
● Demographic shift: People live longer, increase in elderly people, these people make more use
of the healthcare system. Also rising incidence of chronic disease (tobacco use and unhealthy
diets)
● Pace of technological innovations: More ways to treat illness with surgeries or medicine.
● Changing expectations: People want more from health service nowadays, they are better
informed.
● Financial pressures: rising costs due to previously mentioned trends,
● Health crisis: wordt niet benoemd in het boek.
It is difficult to manage professionals because they know what they have to do. Things are not done
through instruction or direction but by negotiating, persuasion, peer influence and agreement.
Why patients in healthcare are different from other public or commercial services:
● Asymmetry in power and information between patient and healthcare provider
● People are at their most vulnerable and less able to act independently and assertively
Why people question how scientific management is:
● Literature written from the ‘craft’ school of thought: books everywhere about management, many
are rubbish, anyone can write them.
● School teach managers how to manage but are mainly focused on scoring points, not about
connecting to real life situations
● Management research has become increasingly irrelevant and disconnected from management
practice.
, There are 3 types of evidence:
● Theoretical evidence: how and why an intervention or initiative is meant to work
● Empirical evidence: what impact the intervention or initiative has had when it has been used and
evaluated.
● Experiential evidence: explore what people do in response to the intervention or initiative
First you have to find evidence by conducting research, then you have to read, appraise and interpret the
literature.
Managers in healthcare should think more and act less. A more reflective and evidence based approach to
decision-making is possible. Commercial interests and political consideration often loom large in
healthcare decisions
There are 2 factors that conflict with each other. First the increasing cost and complexity of healthcare
and second the enduring support for the idea of universal health coverage, in particular, the role of
governments to ensure access to healthcare for entitled citizens when they need it.
Main players in healthcare:
● The state
● The professions: doctors
● Other interest groups: hospitals and insurance companies
● Users and the public
Three different dimensions of control over healthcare systems:
● Financing: Who provides the money for healthcare.
● Health service provision: Who delivers and owns the means of delivering healthcare.
● Regulation or governance: who determines how the system is run.
Path dependency
One of the frameworks used by political scientists to explain why radical policy change does or does not
happen is the concept of ‘path dependency’. This theory suggests that policy decisions made at a
particular time shape the likelihood of subsequent decisions. As time goes by, these decisions shape the
path to the future, increasing the probability of continuing on the same path and decreasing the probability
of deviating from it. Radical reform is never impossible but becomes increasingly unlikely.
Hughner and Kleine (2004) identified 18 themes that fell into 4 categories of how people defined health:
Category 1: Definitions of health (absence of disease, ability to, a state of, etc).
Category 2: Explanations for health (caused or maintained by X)
Category 3: External and/or uncontrollable factors impinging on health (genetic, policy)
Readings:
● Book chapters 1, 2, 3, 8
● Kaissi (2012)
● Wiersinga & Levi (2016)
● Pfeffer & Sutton (2006)
● Rousseau (2006)
Course objectives:
1. Explain why healthcare management exists as a distinctive discipline within management.
2. Understand the systematic challenges healthcare management is facing.
3. Discuss the major defining components of healthcare systems.
4. Outline effective strategies for working with healthcare professionals.
5. Reflect on the relevance of basic management accounting functions in healthcare settings.
6. Argue against which kinds of standards healthcare quality can be evaluated.
Course outline:
● Lectures on mondays
● Tutorials on thursdays
● Podcasts to accompany lectures
● Assignments: 3, during tutorials
Health = A state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity (WHO, 1984)
Health = The ability to adapt and to self-manage, in the face of social, mental and physical challenges of
life (Huber, 2011).k
, 6 factors of health
(BDM, MQP):
● Bodily
functions
● Mental well-
being
● Meaningfulness
● Quality of life
● Participation
● Daily functioning
Lemmen, C. H., Yaron, G., Gifford, R., & Spreeuwenberg, M. D. (2021). Positive Health and the happy
professional: a qualitative case study. BMC family practice, 22(1), 1-12.
Quadruple aim of healthcare (SIRS):
,Management makes a difference in healthcare management.
Challenges for healthcare management:
● Demographic shift: People live longer, increase in elderly people, these people make more use
of the healthcare system. Also rising incidence of chronic disease (tobacco use and unhealthy
diets)
● Pace of technological innovations: More ways to treat illness with surgeries or medicine.
● Changing expectations: People want more from health service nowadays, they are better
informed.
● Financial pressures: rising costs due to previously mentioned trends,
● Health crisis: wordt niet benoemd in het boek.
It is difficult to manage professionals because they know what they have to do. Things are not done
through instruction or direction but by negotiating, persuasion, peer influence and agreement.
Why patients in healthcare are different from other public or commercial services:
● Asymmetry in power and information between patient and healthcare provider
● People are at their most vulnerable and less able to act independently and assertively
Why people question how scientific management is:
● Literature written from the ‘craft’ school of thought: books everywhere about management, many
are rubbish, anyone can write them.
● School teach managers how to manage but are mainly focused on scoring points, not about
connecting to real life situations
● Management research has become increasingly irrelevant and disconnected from management
practice.
, There are 3 types of evidence:
● Theoretical evidence: how and why an intervention or initiative is meant to work
● Empirical evidence: what impact the intervention or initiative has had when it has been used and
evaluated.
● Experiential evidence: explore what people do in response to the intervention or initiative
First you have to find evidence by conducting research, then you have to read, appraise and interpret the
literature.
Managers in healthcare should think more and act less. A more reflective and evidence based approach to
decision-making is possible. Commercial interests and political consideration often loom large in
healthcare decisions
There are 2 factors that conflict with each other. First the increasing cost and complexity of healthcare
and second the enduring support for the idea of universal health coverage, in particular, the role of
governments to ensure access to healthcare for entitled citizens when they need it.
Main players in healthcare:
● The state
● The professions: doctors
● Other interest groups: hospitals and insurance companies
● Users and the public
Three different dimensions of control over healthcare systems:
● Financing: Who provides the money for healthcare.
● Health service provision: Who delivers and owns the means of delivering healthcare.
● Regulation or governance: who determines how the system is run.
Path dependency
One of the frameworks used by political scientists to explain why radical policy change does or does not
happen is the concept of ‘path dependency’. This theory suggests that policy decisions made at a
particular time shape the likelihood of subsequent decisions. As time goes by, these decisions shape the
path to the future, increasing the probability of continuing on the same path and decreasing the probability
of deviating from it. Radical reform is never impossible but becomes increasingly unlikely.
Hughner and Kleine (2004) identified 18 themes that fell into 4 categories of how people defined health:
Category 1: Definitions of health (absence of disease, ability to, a state of, etc).
Category 2: Explanations for health (caused or maintained by X)
Category 3: External and/or uncontrollable factors impinging on health (genetic, policy)
