Health Care System • Variable cost

o cost varies with activity

• has multisectoral / complex organizations
Variance Analysis
Health Systems Management
• comparing actual performance to budget
• measure / improve how health system meets • Actual difference in PHP
goals o e.g. Planned budget 500 PHP, Actual
• Health Manager Spent 600 PHP; VA = 100 PHP
o supervises / leads team to improve care
• Operational Skills Break-Even Analysis
o to Monitor, Evaluate, Plan, Organize
• simplest way to view breakeven point
o ex. checking reagents / machine
• Leading Equipment Cost + Other Fixed costs
BE Point =
o to Motivate / Expand team Volume x Profit margin
o ex. marketing your Clin Laboratory
• Opportunity Cost
Organization / Structure (US) o next best use of resources
• direct patient care Assessing Organizational Performance
• financing health care serviced thru HMOs
Measurement Tools
Non-profit Organization
• to benchmark project
• built on health care Advocacies o comparing org self-assessment to other
• All earnings are just for maintenance, no similar orgs
income taxes • Dashboard
o glance view / graphical representation of
Governance of Health care institutions
performance indicators
• Owner of practice is also manager • Balanced Scorecards
• For Profits organizations o holistic picture of org to link strategic and
o contain a board of directors / stakeholders operational domains
that make decisions for the org o measuring org’s vision / mission / strategy

Financing Mechanisms
Budgeting Strategies

• Capital budgeting
o for evaluating / funding major infrastructure
projects
• Incremental budgeting
o budget built based on previous year/s
expenses
o bad if environment / economy drastically
changes
• Zero-based budgeting
o pretending to start from 0
o expenditures justified by current need
Fixed / Variable Cost

• Financial Forecast improved by distinguishing

b/w costs
• Fixed Cost
o doesn’t change over given time span
 Quality Improvement
National Academy of Medicine
• explains what quality healthcare is
Disaster / Epidemiology Surveillance
Disaster
• event that puts stress on a system
• can’t be faced with daily resources
Uses

• determine Physical / Mental short / long -term

effects
• prevention of death, injuries, disease spread
Burden of Disaster

• estimated 2.6b People are affected annually

• Global Disaster Alert and Coordination System
o gives real-time statistics
Triple Aim
Definitions / Objectives
• factors to achieve proficient healthcare
Descriptive Epidemiology
• improve patient experience
improve population health • reduce number of death / injuries
Reduce per capita health care cost • provide timely / accurate health information of
• Quad Aim groups affected by the disaster
o + team well being • for decision makers
• Quint Aim • improve prevention / mitigation strategies
o ++ Equity • 3 Contexts of Disaster
Assessing Quality Care o describing incidents thru Time / Place /
Person
• Quality examined in diff factors • Registries
• Structure o monitoring long term effects of disaster
o Physical / Human resources
Analytic Epidemiology
• Process
o how Physical / Humans are joined in • Comparing groups to factors related to the
activities event
• Outcome • Knowing difference between 2 groups
o end results of care o Group 1: Injured / Ill during an Event
Disparity o Group 2: Not affected
• gives information on risks and protective
• small area variation analysis, John Wemberg factors of a disaster
Medical Error Evaluative Epidemiology

• failure of planned action • surveillance for effectiveness of strategy

• most errors result f/ chain of events in fault • determine factors that contribute to success /
systems of care failure
Methods / Tools to improve care quality Purpose of Disaster Epidemiology

• Root Cause Analysis • Identify priority / pre-existing health problems,

• Lean cause of disease / injury
• Six Sigma • to know needs of specific services
Forensic Epidemiology

• Public health + Investigative approach

• important in bioterrorism attacks
Disaster Surveillance
Syndromic Surveillance

• usage of health indicators before disease

widespread
• Routine Surveillance
• basis
o Existing Data systems
o ex. DOH / CDC
Challenges in Disaster Surveillance / Epidemiology

• Predefine variables of interest during a

particular disaster
• Surveillance post disasters
Role of Non/Government Agencies
Emergency Management Agencies

• overall management of a disaster response

• coordination of recovery services
• e.g. FEMA / NDDRMC
• RA 10121
o Philippine Disaster Risk Reduction and
Management Act of 2010
o Good governance, reduces underlying risk
factors for disasters
Private / NGOs

• Provides shelter, healthcare, food, clothing

• e.g. Philippine Red Cross