Healthcare Management

Healthcare Administration

What is healthcare management or healthcare administration?

Management of healthcare services or healthcare institutions is known as healthcare management.

Management is the process whereby resources are utilized in a most effective and efficient manner to achieve the objectives of an organization.

Hospitals or clinics or nursing homes aim to provide treatment to patients to cure them from their diseases, injuries or sickness. When cure is not possible, at least some relief can be provided to the patients from their pain or suffering. Patients are required to pay for services. Hospitals expect the patients and their family members to be satisfied with the services. If the hospitals succeed in achieving these objectives, then it can be considered effective. In other words, effectiveness is the degree to which pre-determined objectives of an organization are achieved.

In order to provide the services, hospitals utilize various resources, such as doctors or nurses time, equipment, medicines, operating room, electricity etc. If these resources are utilized judiciously; if they are not misused or wasted, and if the hospital is able to generate profit, it can be considered efficient. Efficiency is the relationship between output and input – what was spent versus what was gained.

What is difference between healthcare management and healthcare administration?

 ‘Administration’ is an old term used mostly in governments. Since there is strong hierarchy, and rules and regulations, and control in the governments, administration is often seen in that perspective. ‘Management’ is relatively a new term and commonly used in private sector. Private organizations are more democratic and efficient. They work on the principles of mutual respect and are result oriented. Accordingly, management is often seen in that respect. However, these differences are just perceptions, not embedded in the meaning of the terms. We can say healthcare management and healthcare administration are virtually same and can be used interchangeably.

What are the types of healthcare organizations?

Healthcare organizations are of several types with very diverse functions. Some of them are:

Hospitals, Clinic, Nursing Homes: When someone falls sick or sustains injury, these institutions provide the treatment. This is known as curative services or medical services or medical care. Hospital services or hospital care are generally used in the context of admitted patients.

Hospital management ensures that the service providers provides appropriate treatment to its patients. The patients get cured or relieved and feel satisfied. In return, the hospital makes some financial gains and earns goodwill.

Johns Hopkins Hospital, Baltimore; Clevland Clinic; Mayos Clinic, Rochester; Mount Sinai Hospital NY; Northwestern Memorial Hospital, Chicago; USA Health University Hospital, AL are some examples of prestigious hospitals.

Public Health Organizations: These organizations work at community level. They primarily provide preventive and promotive services. That means even if people are not sick or injured, these organizations work in association with them to prevent potential threat of diseases or to improve their existing status of health. For example, they organize immunization of children against polio, diphtheria, measles. In a malaria infested area, these organizations work to educate people on how to protect themselves from malaria. They coordinate to provide them insecticide impregnated mosquito nets. They educate and encourage people to use these nets. They guide people traveling to malaria infested areas about how to protect themselves from malaria by taking prophylactic medicines.

Promotive services include educating people on harm of cigarette smoking or excessive consumption of alcohol. Education people on the advantages of physical exercises. Educating people to keep themselves protected from HIV/AIDS.

There are a large number of non-government organizations (NGOs) that work on public health. HIV/AIDS, maternal and child health, tuberculosis, malaria etc. are some of the areas of their interest. CARE, Jhpiego, EngenderHealth, Marie Stopes International are examples of NGOs that work on public health.

Governments also work on public health program. They generally set up chain of health centers in rural and remote areas to provide preventive and promotive services. If they are able do so by spending minimum finances, they can be considered efficient. Public health system is generally not interested in making surplus.

Research Organizations: Some organizations are involved in designing and conducting research on health-related issues. There are several types of research in health sector:

Clinical Research: It is about assessing the efficacy of new drugs. Clinical research organizations conduct clinical trials – initially animal trials and then human trials. These are known as randomized control studies (RCT). One group of patients is given a particular drug and another group is given placebo and then after a gap of time results are compared.

Many pharmaceutical companies are involved in clinical research.

Bio-technology: Some organizations conduct fundamental research to identify a new chemical that could be effective against a specific disease or that may have a specific action. Bio-technology organizations are trying to discover new medicines for diabetes or cancer or resistant tuberculosis.

Social Science Research: This is mostly concerned with behavior and practices of people. For example, it may explore why people in low income countries do not want to control size of their family. Why they do not get their child immunized against polio? Indian Institute of Health Management Research, Johns Hopkins School of Public Health are examples of research organizations.

What is difference between doctors or nurse and healthcare professionals?

Healthcare professionals are of several types. They can be clinical or non-clinical.

Doctors and nurse are clinical professionals. They provide direct patient care. They diagnose the disease of a patient and provide treatment and care. They can attend to patients. In their work, a variety of paramedical professionals’ support them. For example, laboratory technicians conduct laboratory tests; radiologist take x-rays or CT scan or MRI. Physiotherapists give exercises to patients.

Patient care is a small component of healthcare domain. Non-clinical professionals are involved in various domains of healthcare services which do not require clinical expertise. Healthcare management or research or public health are some examples.

What is the role of non-clinical persons in public health?

Non clinical persons can be involved in designing and conducting surveys to assess behavior and practices of people that affect their health; to measure the burden of health problem in a community. They are involved in devising strategies to handle major health problems.

Health communication is a highly specialized area of public health. It decides what messages are to be given to the people and how to reach out to people in remote and rural area, what channels of communication can be effective.

Healthcare project management is a specialized area. It involves preparing program implementation plan, raising a team of health workers for field interventions, their training and monitoring them performing in the field. Monitoring and evaluation plan is prepared to assess the effectiveness of the program. Periodic reports are generated. Man management, financial management and supply chain management are all non-clinical areas and non-clinical healthcare professionals are more suitable for these positions

However, there are some areas where both clinical and non-clinical persons can work depending on their interest.

For further information, refer to book: Hari Singh, Essentials of Management for Healthcare Professionals, CRC Press, Taylor and Francis, 1st edition, 2018.