Distance learning in graduate health administration education: a case study from Washington State University

Some scholars have viewed distance learning as cause for concern, a potential degradation to the educational process. Others have said it provides the access that is not possible with traditional education and therefore expands the options for reaching diverse populations of students. Many are not certain where this educational toolis headed but know that it will have a big effect on the population of both students and faculty in educational institutions. Indeed, the direction of distance learning has the attention of many that previously attempted to ignore it as a passing trend in the educational process. Washington State University (WSU) at Spokane and its Health Policy and Administration (HPA) Program have been involved with distance education for more than a decade. The purpose here is to share this decade of experience. The academic and administrative experience of faculty, staff, and students are documented and discussed with the intent of showing both the advantages and disadvantages of distance learning. Some of the lessons learned are shared along with challenges in maintaining quality in the delivery of graduate education in health administration and other fields as we move forward in adopting distance learning tools and techniques.     

The academic elite in health services administration: linkages among top-ranked graduate programs

The eleven top-ranked graduate programs in health services administration, based on a national survey of deans, top administrators, and senior faculty, were linked to one another by hiring one another's graduates. It is suggested that this linkage helps these programs maintain and enhance their prestige.     

Crossing the quality chasm: implications for health services administration education

Programs in Health Services Administration (HSA) should respond to the mandate to improve patient care as put forth by the Institute of Medicine (IOM) and other reports on the proliferation and consequences of medical errors. This article will identify a framework to base curriculum change, competency areas, and educational methods to impart quality improvement knowledge and skills. The first six competency areas reflect the six redesign imperatives from the IOM report, Crossing the Quality Chasm: A New Health System for the 21st Century (2001): redesign of the care process; use of information technologies; knowledge and skills management; development of effective teams; coordination of care; and use of performance and outcomes measurement. Based on a literature review, five additional areas were identified: strategic quality planning; programs for patient safety and risk management; change management; roles of stakeholders, payers and regulators; and development of a learning environment and blame-free culture. Examples of curriculum content are provided from HSA programs at Georgetown University, University of Washington, and University of California at Berkeley.     

Public health services in Shenzhen: a case study

As one of the fastest growing cities in Pearl River Delta of southern China, Shenzhen accommodates a higher percentage and increasing number of internal migrants, mainly coming from the inland areas. The public health issues that challenge its local government include the special population structure, high incidence of infectious diseases, high prevalence of mental problems, rising chronic disease burdens, and maternal and children's health issues, although progress has been made in the past years. The health authority of?Shenzhen has realized that provision of high quality equitable public health services to its residents, including migrants is of high priority, and should be supported by innovations in the health insurance system and establishment of community-based primary care networks. Making changes within the national-level health reform framework and learning from international experiences are necessary and important.     

Use of the Internet for real-time class instruction in a graduate health services administration program.

The Internet has been used as a medium for distance learning for several years. Many universities are using Internet technologies such as electronic mail, LISTSERVs, newsgroups, and web pages to supplement or replace traditional classroom meetings. However, these modes of communication when used in place of traditional classroom instruction lack the interactivity among students and between the students and the instructor that would be achieved in the ideal classroom setting. Internet teleconferencing, however, appears to offer the opportunity for real-time, interactive class meetings on the Internet. This paper details the use of the Internet for real-time teleconferencing as a substitute for classroom meetings at the graduate university level, and offers some insight into the quality and usability of Internet teleconferencing given currently available hardware, software, and communications links.     

Evolving health services administration education: keeping pace with change

Virginia Commonwealth University (VCU) celebrated its golden anniversary in 1999. It was an occasion for faculty and alumni to renew memories of their experiences together and marvel at the dramatic changes they have seen in the health care industry. This qualitative study was undertaken to reflect on the department's immediate future course, and to learn how to reposition the education program and curricula to respond to evolving industry needs and demands. Results and conclusions are based on interviews conducted with several stake-holder groups, including VCU alumni, who are executives in the health sector; human resources recruitment officers; and selected program directors from leading health administration (HA) education programs in the U.S. Trends are identified in the health care industry environment, and strategies are proposed for the HA education programs to strategically adapt for the future.     

Decentralizing rural health services: a case study in China

Many low and middle-income countries have decentralized their public health services in an effort to improve their equity, efficiency and effectiveness. This paper presents a case study of a poor rural county in China that devolved finance and management of basic health services to townships, the lowest level of government. It finds little evidence that townships mobilized additional financial resources or that they were able to address major management problems effectively. It cautions against unrealistically rapid decentralization of health services in poor rural areas.     

The demand for episodes of mental health services

Observational studies of demand for mental health services showed much greater use by those with more generous insurance, but this difference may have been due to adverse selection, rather than in response to price. This paper avoids the adverse selection problem by using data from a randomized trial, the RAND Health Insurance Experiment (HIE). Participating families were randomly assigned to insurance plans that either provided free care or were a mixture of first dollar coinsurance and free care after a cap on out-of-pocket spending was reached. We estimate that separate effects of coinsurance and the cap on the demand for episodes of outpatient mental health services. We find that outpatient mental health use is more responsive to price than is outpatient medical use, but not as responsive as most observational studies have indicated. Those with no insurance coverage would spend about one-quarter as much on mental health care as they would with free care. Coinsurance reduces the number of episodes of treatment, but has only a small effect on the duration and intensity of use within episodes. Users appear to anticipate exceeding the cap, and spend at more than the free rate after they do so.     

Articulation of undergraduate and graduate education in health administration: barriers and strategies for the future

The initiation of the hospital administration degree at the master's level and not the baccalaureate level was an intentional decision. Unfortunately, during this formative half-decade, the baccalaureate programs developed in a vacuum, isolated from one another and from the long-established graduate programs. While there is not a clear professional consensus that the lack of undergraduate degree articulation with graduate education is a problem, the authors believe this to be the case and believe that many faculty agree. This paper will address the history of health administration education, current academic pathways to careers in health administration, and detailed barriers and strategies to academic degree articulation. The paper concludes that discussion of health administration degree articulation has received modest attention and discussion for more than twenty years, and neither formal relationships nor certification/accreditation has addressed the issue. The authors believe that creation of articulated degrees is desirable and call for AUPHA and CAHME to develop a task force to address barriers and strategies for articulation. Concurrently, while national policy would facilitate more rapid change, we recommend that individual undergraduate and graduate degree programs explore individual relationships as a means to achieve models for the profession as an alternative to the status quo.     

The policy context of health services administration education through outcomes assessment

Effectively evaluating preparation programs for health services administrators is important for program providers, trainers, future employers, the health care system, and the American public. Because the methods employed for evaluation do not exist in a vacuum, policy formation with respect to learner outcomes assessment is a critical concern for all those interested in health care management issues. During the 1990s, the prevalent trend in evaluation is "assessment," which emphasizes performance-oriented outcomes rather than traditional testing approaches. This article examines the evolving role of assessment from a higher education policy perspective. Current trends and issues in general education, teacher testing, and nursing home administrator preparation are brought to bear on the problem of how to implement the goals of assessment. Realistic expectations of assessment are subsequently offered.