Health Systems in Europe

Full course description

1. Summary The aim of this module is two-fold: first, to explore the harmonization of health systems and the impact of health care reforms in Europe with special attention given to health systems in transition and second, to analyze the European challenges of cross-border care and patient mobility given by the execution of the sanction of the European Union of the free movement of goods, individuals, services, capital and payments in terms of health. The aims will be achieved through self-study, tutorials, lectures, group work and field trips introducing students to relevant parts of health economics, organizational and network theory as well as cases and best practices from the field. The module prepares the excursion to Poland (3.1.3) to apply knowledge and gain insight of an eastern European health system in transition. The module builds on knowledge already gained in the programme, especially in semester 2. In semester students are introduced to the European institutions and the legal basis for the EU taking up health issues. This module now focuses much more on national health systems and national health systems within the context of European policy and practice. 2. Content The module introduces a system approach to health in Europe. The responsibility of providing access to health is placed within the Member States of the European Union, and therefore there is a high degree of diversity within the organization of health systems among European countries. With the enlargement of the EU an even bigger gap is seen between countries having a highly developed system of provision of health services and countries facing severe difficulties in meeting the needs of their populations. The module will focus on the European differences paying special attention to Eastern European countries with health systems in transition – a special focus will be on Poland (cf. module 3.1.3 which is thus being prepared). Due to the enormous political and socioeconomic changes the countries in the region have engaged in various health reforms and challenges still lie ahead in the transition process such as strengthening of the health care financing, provision of a continuum of care, improving the quality of health services, linking up with communities and advancing in public health . In the module special attention will be given to theory on the organization of health services, basic health economics and the financing of health systems in order to enhance the ability to analyze health systems in a European perspective. Cross-border care is included as an emerging field of interests from patient’s points of view as well as from decision maker’s point of view. Cases from the European Court of Justice have raised the awareness among politicians and providers of the need for a closer cooperation among Member States, and also the effect of a change in health consumer behaviour and patient mobility in Europe influencing the way Member States in the EU are organizing the national health systems and tackling the demand for treatments carried out as cross-border care. Though the number of patients and professionals crossing borders might not seem alarming in a Europe wide perspective, the implications and consequences are complex for all stakeholders involved and introduce challenges for patients and professionals as well as policy makers and providers. The module provides the students an opportunity to analyze regional cross- border projects in order to create awareness of these challenges facing Europe now and in the near future. Organizational theory as well as theory on networking is presented as tools to analyze cross-border care and health systems in transition. 3 Academic Thinking Health care systems can be positioned in different domains of society, namely as systems that contribute to the dynamics of the state and the market or to the dynamics of daily life and social participation of citizens. So constructed, each system offers its own internal dynamics with distinct functions and operations which might be at conflict with the functions and operations being distinct for related systems. The interconnection of this system ‘interplay’ will be addressed, showing how various systems claim they operate in the ‘interest’ of the citizen, yet displaying differential effects on autonomy, choice and good life of citizens. Thus, the notion of ‘transition’ (or related concepts such as progress and innovation) can be identified as a social arena, in which different notions of justice and injustice in public health practices are emerging, struggling and conflicting with each other. Coordinator: Rein Vos Department of Health Ethics and Philosophy 043 38 81130 R.Vos@zw.unimaas.nl 4. Skills Training In this module students will be focus at two different domains. They will be introduced to writing their first drafts of a curriculum vitae and a covering letter; but first students will be trained in bargaining and negotiation skills. As they will be working in a society which can be described a bargaining society, learning these skills will be important for their professional life. In workshops they will learn the basics of distributive bargaining and integrative negotiation. Negotiation skills will be important for students’ professional life. Later on they have to negotiate with many parties: a boss, (a) member(s) from another country / countries, people from other institutions active in the field of European Public Health. Negotiations will become a part their daily life. As an EPH-professional a student should be able to negotiate in a purposeful and intentional way. In the six workshops students are offered practical experiences and theoretical information about the most important components involved in a negotiation process.The examples and practical exercises will be based on public health professional context. In this semester 1 plenary lecture and six workshops around the skill of ‘Negotiation’ will be offered The Module will cover such topics as: the interdependence between the negotiators, the possibilities to claim value but also to create value for all parties involved, strategies and tactics of distributive negotiation (often distributed negotiation is also called bargaining) as well as integrative negotiation, planning and chairing negotiations, negotiating in situations in which multiple parties are involved, parties which could have a very different cultural background. There will be one plenary lecture and three –three-hour workshops: Workshop 1: What do you know and what do you want to know about negotiation? Workshop 2: Distributive bargaining: win- lose negotiations Workshop 3: Integrative negotiation (1): win –win negotiations Workshop 4: Writing a CV Coordinator: Kasia Czabanowska Department of International Health 043 - 38 81592 Kasia.Czabanowska@inthealth.unimaas.nl 5. Methodology In terms of methodology the objective is to provide specific issues regarding cross national and cross cultural comparison with a special focus on health management, health financing and cross-border care. Furthermore, a focus will be on research in the field of economics. Coordinator: Anja Krumeich Department Health, Ethics and Society 043 38 81122 a.krumeich@zw.unimaas.nl 6. Epidemiology Sampling and sample size calculation will be addressed in this module. Coordinator: Matty Weijenberg Department of Epidemiology 043 38 82358 mp.weijenberg@epid.unimaas.nl 7. Statistics No Statistics.