Program directors' recommendations for transforming health services management education

A survey of graduate program directors shows that they recognize major change taking place in the health services industry and the need for programs to respond with curriculum revision. The revisions proposed tend to emphasize more practice involvement and human resources management skills rather than increased quantitative and financial competencies. Is this the right direction for programs to take? Will such revisions produce graduates better able to manage and lead in the emerging health care environment? We need more evidence-based research to answer these questions. In the meantime we have developed an environmental typology suggesting some rather clear distinctions among programs according to their settings. We know that the resulting categories of programs vary according to their national reputations and the kind of students that they serve. Do these different categories of programs prepare their different students well for the changing health care environment? Our current evidence, again, is sparse, indicating the need for further research.     

The role of evaluation in decision-making in the management of health services

The management of health services is a complex administrative practice due to the breadth of the field of health and the need to reconcile individual, corporate and collective interests that are not always convergent. In this context, the evaluation needs to have specific characteristics in order to fulfill its role. The scope of this study was to establish the characteristics that the evaluation for the management of health services should have to contribute to decision-making. Usefulness, opportunity, feasibility, reliability, objectivity and directionality represent the set of principles upon which the evaluation should be based. Evaluations should lead to decisions that guarantee not only their efficiency and effectiveness but also their implementation. The evaluation process should ensure that decisions involve all stakeholders in order to render the implementation of decisions feasible, and take into account the health needs of the population and the goals set for the services. The scope of this article is to elicit a debate among different stakeholders in the evaluation in the hope that it can contribute to the reflection on the real usefulness of evaluations in which the political component in management has been increasingly prevalent.     

An examination of role identification by students in health education and health services administration

This research was designed to test the extent to which health education and health services administration students' perceptions of their roles as professionals matched the expectations of professional faculty. These perceptions were found to match in general. However, doubt was cast on the extent to which internships or practicums contributed to this result, since there was no change in student responses between the beginning of the junior year and end of the senior year, a period which includes fieldwork and most of the professional coursework presumed to influence professional development. Additional research is required to test this result with other student populations in other health professions and identify the point at which professional role and task definitions are amenable to change.     

The role of public health services in prevention

Huge population migration, increasing unemployment and poverty and unhealthy lifestyles (stress, smoking, alcohol consumption, etc), among the population in Serbia, are some of the consequences of the political and economic instability in the Balkan region over the last decade (especially in countries of the former Yugoslavia). Data available reveal that, in Serbia, chronic noncommunicable diseases are the dominant cause of death. The National Burden of Disease and Injury Study, done in 2003, showed that cardiovascular diseases, cancers and injuries are responsible for 80% of the total mortality burden in both males and females. The health-care system of Serbia is excessively centralized. The public health services are based on the traditional hygiene and clinical approach and are predominantly organized through a network of Institutes of Public Health which puts insufficient emphasis on analytical and planning tasks and on health promotion (including the prevention of chronic noncommunicable diseases), and too much emphasis on routine reporting and on activities of a technical and laboratory nature in the field of communicable diseases. Today, with the aid of the EU, UNICEF, the World Bank and NGOs, the Ministry of Health is in the process of expanding the capacities and skills of the public health workforce in order to achieve the New Public Health. Although progress has been made on several important fronts in achieving the transition to the New Public Health, this does not yet extend to the wider community. Policy documents and legislative instruments have been drafted to guide the reorganization and reorientation of the public health services, especially the network of Institutes of Public Health, and the creation of the Centre School of Public Health has secured the future of professional public health training. The authors argue that the reform of the health sector should be placed within the context of the overall reform of public administration in the country. In this respect, much of the journey still lies ahead, but experience within public health can be used to stimulate, motivate and encourage professionals throughout the civil service to grasp the opportunities for positive change with both hands.     

A framework for evaluating the impact of health services management education

The objectives of this paper are three-fold. The first is to propose a conceptual and analytical framework for planning and evaluating health services management education programs. The framework was developed in response to the health care industry restructuring and the emerging questions and concerns regarding how to strategically redesign the educational programs for the twenty-first century. Additionally, it was used to develop a questionnaire for the 1998 National Survey of Program Directors. The second objective is to suggest variables for operationalizing the framework as the field considers initiatives such as, "Evidence-Based Health Administration Education" (AUPHA Education Outcomes Task Force 1999; Griffith 2000) and other more standardized, quantifiable approaches to assessing program quality. The third objective is to report selected results from the 1998 National Survey of Program Directors focusing on the major changes impacting the health services industry and the implications for management education and development. In the future, ACEHSA and other accrediting commissions will likely consider evidence-based evaluation criteria for assessing and improving education program quality. The framework presented in this paper can be used as a starting point for conceptualizing and developing valid and reliable measures.