health, management, definition of management, health services, manager, leader, plan

1. HEALTH MANAGEMENTHEALTH MANAGEMENT
Amany Rashad Abo-El-SeoudAmany Rashad Abo-El-Seoud
Prof. of Community MedicineProf. of Community Medicine
Zagazig University,EGYPTZagazig University,EGYPT

2. HEALTH MANAGEMENTHEALTH MANAGEMENT
ObjectivesObjectives::
 Definitions ,benefits of managementDefinitions ,benefits of management
 Identify the main managementIdentify the main management
functionsfunctions
 How to plan for research studyHow to plan for research study
 How to manage an organizationHow to manage an organization

3. Definition of managementDefinition of management
 Group of activities done for reaching goals.Group of activities done for reaching goals.
Management is getting thingsManagement is getting things effectivelyeffectively done todone to
achieve desired objectives through properachieve desired objectives through proper
planning,planning, efficientefficient implementation, andimplementation, and
evaluationevaluation to assess achievements and identifyto assess achievements and identify
the needs for re-planning. Management is thus athe needs for re-planning. Management is thus a
dynamic process in the workdynamic process in the work systemsystem..
 AdministrationAdministration implies the use of formal and
hierarchical lines and procedures to accomplish
a given work.

4. Strategic managementStrategic management
 StrategyStrategy is the art and science of mobilizationis the art and science of mobilization
the forces into the most advantageous positionthe forces into the most advantageous position
prior to actual engagement with the enemy.prior to actual engagement with the enemy.
 ManagementManagement is the handling of tools andis the handling of tools and
techniques to achieve a desired goal .techniques to achieve a desired goal .
 Strategic ManagementStrategic Management it is an art andit is an art and
science of formulating, implementing andscience of formulating, implementing and
evaluating the cross functional decision thatevaluating the cross functional decision that
enables an organization to achieve itsenables an organization to achieve its
objectives.objectives.

5. Benefits of StrategicBenefits of Strategic
PlanningPlanning
 It improves financial performanceIt improves financial performance
 It provides the organization with self concept, specificIt provides the organization with self concept, specific
goals.goals.
 Encourage managers to understand the present plan forEncourage managers to understand the present plan for
the future and understand when change is vital.the future and understand when change is vital.
 Requires managers to communicate vertically andRequires managers to communicate vertically and
horizontally.horizontally.
 Improve over all coordination and encourage theImprove over all coordination and encourage the
changes to meat the challenges of the complex andchanges to meat the challenges of the complex and
evolving environment .evolving environment .

6. SYSTEMSYSTEM
A set of interrelated and interdependentA set of interrelated and interdependent
processes designed to achieve commonprocesses designed to achieve common
objectivesobjectives
Each process in the system has
various inputs which are processedprocessed to
produce certain outputs, that together,
accomplish the overall goal of an
organization.

7. There is ongoing feedback among these
various parts to ensure they remain aligned
with overall organization goals.
SYSTEM
INPUTS PROCESS OUTPUTS
Feedback
There are several classes of systems,
ranging from very simple frameworks all the
way to social systems, which are the most
complex.

8. The Management Process (System View)The Management Process (System View)
Resources
Human
Financial
Physical
Informational
Goal
Achievements
Management Functions
Planning Organizing Directing Controlling
Process OutputsInputs

9. Health Systems PerspectiveHealth Systems Perspective ((Macro-LevelMacro-Level))

10. Health Systems PerspectiveHealth Systems Perspective ((Meso-LevelMeso-Level))
InputsInputs
• patients
• payment
• H.personnel
•instrument
OutcomeOutcome
(Patient)
• recovers
• under medical
supervision
• dies
ProcessorProcessor
(Hospital)(Hospital)
• perform surgery
• providing
nursing care
• feed and house
patient
(Hospital is
convenient to
population it services)
(Older patient
with family
members to
help
supervise
care)
(High inflation
impacting
indirect cost for
supplies)
(Shortage of persons
prepared in
management
information)

11. Micro level of managementMicro level of management
 Health care provider patientHealth care provider patient
Inputs process outputInputs process output
(Factors in doctor) (factors in patient)(Factors in doctor) (factors in patient)

12. Schools of ManagementSchools of Management
The Classical PerspectiveThe Classical Perspective (Scientific managementScientific management):
focuses on ways to improve the performanceperformance of
individual workers.
The Administrative Management Perspective:The Administrative Management Perspective:
focuses on managing the totaltotal organization.
The Behavioral Perspective:The Behavioral Perspective: motivation, etc…
The Quantitative PerspectiveThe Quantitative Perspective (Management
Science): focuses on mathematical models
The Integrating PerspectiveThe Integrating Perspective (System AnalysisSystem Analysis).
The contingency perspective:The contingency perspective: managerial behavior
depends on the situationsituation elements.

13. Scopes of H. managementScopes of H. management
In scientific research, thesis, projects,In scientific research, thesis, projects,
program, experiment, medical servicesprogram, experiment, medical services
(hospital, health units, clinics) to add(hospital, health units, clinics) to add
something new (new technique orsomething new (new technique or
treatment) or to improve somethingtreatment) or to improve something
already present in these areas and needsalready present in these areas and needs
improvement management techniques.improvement management techniques.

14. Management functions:Management functions:
 Where are we now? =Where are we now? = situational analysissituational analysis
 What can we do? formulation of the vision,What can we do? formulation of the vision,
mission, goals,mission, goals, objectivesobjectives
 How can we reach these objectives?How can we reach these objectives? ByBy
planningplanning. (or preparation). (or preparation)
 How to activate the plan?How to activate the plan? ImplementationImplementation
(execution, to do, to act, to perform): to make(execution, to do, to act, to perform): to make
plan real.plan real.
 Do I reach my stated objectives? Do I succeedDo I reach my stated objectives? Do I succeed
to solve the problem? =to solve the problem? = EvaluationEvaluation

15. Management cycleManagement cycle
Situational analysis
Plan
Act
Evaluate
Set objectives
Prioritize
Money
Man power
Materials
Time
Supervision
monitoring

16. Situational analysis SWOTSituational analysis SWOT::
 I-internal assessment :
 strength(S). Weakness(W) .
 * Reviewing the current objectives
 * Reviewing health care units.
 * Technical facilities.
 * Services facilities.
 * The possibilities of integration with training and research
centers
 * Financial position of the institution
 * Performance
 * Human resources
 * Internal clients' assessment

17.  II- External assessment:
 Opportunities (O) and Threats (T)
 * Review demographic & economic data
 * Market research
 * Review the health care delivery regulations
and any expected changes
 * Analyze competitors: ” This is the most
important issue”

18. Situational analysis forSituational analysis for
community health includescommunity health includes
1-Political and administrative rules1-Political and administrative rules
2. Demographic features2. Demographic features
3-Economic resources3-Economic resources
4-Social stratification and relations4-Social stratification and relations
5-5-Leadership pattern and its influence.Leadership pattern and its influence.
6-6-Community organizations and their functionsCommunity organizations and their functions
and activitiesand activities
7-7-Cultural facets or traditionsCultural facets or traditions
8-8-Health, nutrition, and sanitation levelsHealth, nutrition, and sanitation levels
9-9-Education levelsEducation levels

19. Criteria for selecting priorityCriteria for selecting priority
problems on community basisproblems on community basis
11--The extent of the problem (prevalence, incidence ratesThe extent of the problem (prevalence, incidence rates(.(.
2- Seriousness of the problem2- Seriousness of the problem
* Urgency * Severity* Urgency * Severity
* Economic costs * Impact on others* Economic costs * Impact on others
3-Effect on economy and productivity, and other socio-3-Effect on economy and productivity, and other socio-
economic implications.economic implications.
4-Availability of cheap feasible technologies for prevention4-Availability of cheap feasible technologies for prevention
and controland control
5-Single, or multi-sectoral approach, and the feasibility of5-Single, or multi-sectoral approach, and the feasibility of
implementation and monitoring of the program.implementation and monitoring of the program.
6-Time required for achieving visible results.6-Time required for achieving visible results.

20. 1- Identifying and Defining the1- Identifying and Defining the
problem:problem:
Consider these questions:Consider these questions:
What is the problem? Is it my problem?
Can I solve it? Is it worth solving?
Is this the real problem, or merely a symptom of a larger
one?
If this is an old problem, what's wrong with the previous
solution?
Does it need an immediate solution, or can it wait?
Is it likely to go away by itself? Can I risk ignoring it?
Does the problem have ethical dimensions?
What conditions must the solution satisfy?
Will the solution affect something that must remain
unchanged?

21. The Problem StatementThe Problem Statement: a statement of the specific
problem or need to be addressed by the service/project.
It should include some basic data (baseline data(
that help to explain the problem, including the
following information:
•A description of the extent, scope, or severity of
the problem, so that the proposed results can be
put in perspective.
•A description of the geographic area and
demographic characteristics of the population in
the area in which the problem exists.
•An analysis of the causes of the problem.
•The results of previous efforts, by your program or
other programs, to solve the problem.

22. 2. Identify alternative approaches to resolve the2. Identify alternative approaches to resolve the
problem:problem:
At this point, it's useful to keep others involved (unless
you're facing a personal problem(.
Brainstorm for solutions to the problem:
Very simply put, brainstorming is collecting as
many ideas as possible, then screening them to
find the best idea.
It is critical when collecting the ideas not to
pass any judgment on them -- just write them
down as you hear them.
Weigh Alternatives: After listing possible alternatives,
evaluate them without prejudice, no matter how
appealing or distasteful.

23. 3. Select an approach to resolve the problem:3. Select an approach to resolve the problem:
When selecting the best approach, consider:When selecting the best approach, consider:
a. Which approach is the most likely to solve the
problem for the long term?
b. Which approach is the most realistic to accomplish
for now? Do you have the resources? Are they
affordable? Do you have enough time to implement
the approach?
c. What is the extent of risk associated with each
alternative?

24. 4. Plan the implementation of the best alternative4. Plan the implementation of the best alternative
(this is your(this is your Action PlanAction Plan))
5. Monitor implementation of the plan:5. Monitor implementation of the plan:
Monitor the indicators of success:
a. Are you seeing what you would expect from the
indicators?
b. Will the plan be done according to schedule?
c. If the plan is not being followed as expected, then
consider: Was the plan realistic? Are there sufficient
resources to accomplish the plan on schedule? Should
more priority be placed on various aspects of the
plan? Should the plan be changed?

25. 6. Verify if the problem has been resolved or not:6. Verify if the problem has been resolved or not:
One of the best ways to verify if a problem has been
solved or not is to resume normal operations in the
organization.
•Still, you should consider:
a. What changes should be made to avoid this type of
problem in the future? Consider changes to policies
and procedures, training, etc.
b. Lastly, consider "What did you learn from this
problem solving?" Consider new knowledge,
understanding and/or skills.
c. Finally, consider writing a brief memo that highlights
the success of the problem solving effort, and what you
learned as a result. Share it with your supervisor, staff, ..

26. Management functionsManagement functions
 1- PLANNING1- PLANNING
 2- PERFORMANCE2- PERFORMANCE
 3- EVALUATION3- EVALUATION

27. Planning is one of the most importantPlanning is one of the most important
management functionsmanagement functions
Planning is preparing a sequence of actionPlanning is preparing a sequence of action stepssteps
to achieve some specific goal (s)to achieve some specific goal (s)
If you do it effectively, you can reduce much theIf you do it effectively, you can reduce much the
necessarynecessary time and effort of achieving the objectives.time and effort of achieving the objectives.
A plan is like a map (Road Mapping):A plan is like a map (Road Mapping):
[[When following a plan, you can always seeWhen following a plan, you can always see
how much you have progressed towards yourhow much you have progressed towards your
objectives and how far you are from yourobjectives and how far you are from your
destination (goal)]destination (goal)]

28. PlanningPlanning is the process of developing and analyzing
the organization's vision, mission, goal (s(, objectives,
general strategies, values, and allocating resources.
Simply, planning is identifying:Simply, planning is identifying:
 Where you want to go?Where you want to go?
 Why you want to go there?Why you want to go there?
 How you will get there?How you will get there?
 What you need in order to get there? andWhat you need in order to get there? and
 How you will know if you're there or not?.How you will know if you're there or not?.

29. Basic Overview of Typical Phases in PlanningBasic Overview of Typical Phases in Planning
Whether the system is an organization, program,
project, etc., the basic planning process includes similar
nature of activities carried out in similar sequence:
1. Reference Overall Vision and Mission
2. Analyze the Situation (needs assessment)
3. Establish Goals
4. Establish Objectives Along the Way to Achieving Goals
5. Allocate responsibilities and time lines with each objective
6. Write and Communicate a Plan Document
7. Acknowledge Completion and Celebrate Success

30. VisionVision::
 vision statement or what the institution strive tovision statement or what the institution strive to
be, declares the institutionbe, declares the institution’’s intent ands intent and
aspiration to the future (Brown, 2000).aspiration to the future (Brown, 2000).
 The vision is to target while strategic planning isThe vision is to target while strategic planning is
an arrow to it (Coile, 1994).an arrow to it (Coile, 1994).
A vision statement is a concise expression of youryour
organizationorganization’’s best futures best future, of what it dreams
to be.
Ex:
“ Healthy people in healthy communities”

31. MISSIONMISSION
While the vision statement sets out a broad picture
of what your organization will be in the future, the
mission statement is a more practical and precise
description of your organization’s reason fororganization’s reason for
existence.existence.
It is concerned with scope of the services and what
distinguishes this organization from others
(governmental, private, NGOs, etc..).
Many people refer to an organization’s
mission statement as its IDID (Identification
Card).

32. MissionMission::
 The mission is a statement of purposeThe mission is a statement of purpose
 What are the main services?What are the main services?
 Who is our customer?Who is our customer?
 How do we offer this service?How do we offer this service?
 Mission is flexible, dynamic, and capableMission is flexible, dynamic, and capable
of responding to services as they occurof responding to services as they occur

33. Goal and ObjectivesGoal and Objectives
Goals:Goals: are broad statements of what ultimately wantedare broad statements of what ultimately wanted
to be achieved. It should meet the institutionto be achieved. It should meet the institution
mission and vision.mission and vision.
EX:EX: Goal of the government as regard health is to achieve theGoal of the government as regard health is to achieve the
coverage of basic health care services for each and every onecoverage of basic health care services for each and every one
of its citizens (Egypt health Reform, 2000)of its citizens (Egypt health Reform, 2000)
Objectives:Objectives: it represent short term target it must beit represent short term target it must be
specific in certain goal area it must be measurablespecific in certain goal area it must be measurable
by certain indicator.by certain indicator. EX:EX:
1.1. To decrease maternal mortality from 174 per 100,000 in1993To decrease maternal mortality from 174 per 100,000 in1993
to 50 per 100,000 in 2010.to 50 per 100,000 in 2010.
2.2. To decrease infant mortality from 52.7 / 1000 live birth in 1997To decrease infant mortality from 52.7 / 1000 live birth in 1997
to 20/1000 in 2010.to 20/1000 in 2010.
3.3. To reduce cigarette smoking to prevalence of no more thanTo reduce cigarette smoking to prevalence of no more than
10% of the population in 2010 it is 21 percent in 1998.10% of the population in 2010 it is 21 percent in 1998.

34. ValuesValues
The value represents organization philosophy, principle andThe value represents organization philosophy, principle and
ideals. The values are the basic of culture. (Barrett andideals. The values are the basic of culture. (Barrett and
young, 1999)young, 1999)
The following are the value statement given by EgyptThe following are the value statement given by Egypt
health reform (2000)health reform (2000)
Universality:Universality: covering the entire population with a basiccovering the entire population with a basic
package of priority services.package of priority services.
QualityQuality: improving and assuring the standard of quality to: improving and assuring the standard of quality to
meet public satisfaction.meet public satisfaction.
EquityEquity: all regions in the country and people of all income: all regions in the country and people of all income
levels will have a fair share in the health system.levels will have a fair share in the health system.
SustainabilitySustainability: Ensuring the continuity for the future: Ensuring the continuity for the future
generationgeneration

35. Implementation functionsImplementation functions::
 OrganizingOrganizing
 Staffing: Proper selection and training of humanStaffing: Proper selection and training of human
resources to ensure good performanceresources to ensure good performance
 Directing and leadership: Leadership is the art orDirecting and leadership: Leadership is the art or
process of influencing people so that they will striveprocess of influencing people so that they will strive
willingly toward the achievement of a group goal.willingly toward the achievement of a group goal.
 Coordination of work and team buildingCoordination of work and team building
 Recording and reportingRecording and reporting
 Monitoring, and SupervisionMonitoring, and Supervision

36. Evaluation & monitoringEvaluation & monitoring
 MonitoringMonitoring:: is the maintenance of regularis the maintenance of regular
checking of ongoing activities or programs withchecking of ongoing activities or programs with
respect to defined objectives.respect to defined objectives.
 The purpose is to record what the system isThe purpose is to record what the system is
actually doing at present and to detect possibleactually doing at present and to detect possible
deviations from the decided course of action.deviations from the decided course of action.
 Where there are deficiencies, control andWhere there are deficiencies, control and
correction decisions and measures must follow.correction decisions and measures must follow.
 Monitoring is concerned withMonitoring is concerned with Work progress,Work progress,
Staff performance, Service achievementStaff performance, Service achievement

37. Monitoring is done forMonitoring is done for
 InputsInputs: e.g. staff availability, supplies, etc.: e.g. staff availability, supplies, etc.
 ProcessProcess: e.g. standards of performance,: e.g. standards of performance,
 OutputsOutputs: e.g. records, reports, etc.: e.g. records, reports, etc.
 Managers and supervisors monitor work through:Managers and supervisors monitor work through:
 -- Continually observing work progress, staffContinually observing work progress, staff
performance and service achievementsperformance and service achievements
 -- Using check lists (e.g. supplies against inventoriesUsing check lists (e.g. supplies against inventories
and stock-lists)and stock-lists)
 -- Examining recordsExamining records
 -- Discussing difficulties with staffDiscussing difficulties with staff

38. SupervisionSupervision
 Is to make sure that the staff perform their duties effectively.Is to make sure that the staff perform their duties effectively.
 It means that a supervisor helps and guides the staff and trains them asIt means that a supervisor helps and guides the staff and trains them as
necessary in such a way that they become more competent and keep thenecessary in such a way that they become more competent and keep the
standard of work.standard of work.
 Objectives of supervision:Objectives of supervision:
 - To maintain the expected quantity and quality of a health team work.- To maintain the expected quantity and quality of a health team work.
 -- To assess the performance of team members.To assess the performance of team members.
 -- To identify some causes of work deficiency, e.g. insufficiency ofTo identify some causes of work deficiency, e.g. insufficiency of
resources, lack of training, lack of motivation of employees, personalresources, lack of training, lack of motivation of employees, personal
problems, unclear job descriptions......problems, unclear job descriptions......
 -- To help resolve dispute among team members.To help resolve dispute among team members.
 -- To help with personal problems.To help with personal problems.
 -- To trainTo train.. (On-the-job training)(On-the-job training)
 Supervision methods: Observation checklist, Record review, Review ofSupervision methods: Observation checklist, Record review, Review of
reportsreports
 In all cases you should discuss with the employee and correct deficiencies.In all cases you should discuss with the employee and correct deficiencies.

39. EvaluationEvaluation
 Evaluation is a judgment of value based on measuring orEvaluation is a judgment of value based on measuring or
assessing the achievements of program activities.assessing the achievements of program activities.
 Evaluation is intended to measure the degree to whichEvaluation is intended to measure the degree to which
the objectives of the program have been achieved; tothe objectives of the program have been achieved; to
identify pitfalls, and constraints; and to help re-planningidentify pitfalls, and constraints; and to help re-planning
for correction.for correction.
 Evaluation is concerned with effectiveness andEvaluation is concerned with effectiveness and
efficiency. Evaluation would thus consider all the steps ofefficiency. Evaluation would thus consider all the steps of
program planning, and implementation, and will assessprogram planning, and implementation, and will assess
input, process, output, outcome and impact. Evaluationinput, process, output, outcome and impact. Evaluation
uses Indicatorsuses Indicators

40. METHODS OF EVALUATIONMETHODS OF EVALUATION
 Describe the program/project or activities to beDescribe the program/project or activities to be
evaluated.evaluated.
 Determine the overall goals and specificDetermine the overall goals and specific
objectives of the program/project.objectives of the program/project.
 Identify the indicators to be used.Identify the indicators to be used.
 Develop the evaluation design.Develop the evaluation design.
 Collect dataCollect data
 Analyze and interpret these dataAnalyze and interpret these data
 Utilize the evaluation results in decision makingUtilize the evaluation results in decision making
for corrective actionsfor corrective actions

41. QUALITY MANAGEMENTQUALITY MANAGEMENT
ObjectivesObjectives::
 Define qualityDefine quality
 Explain the criteria of quality in healthExplain the criteria of quality in health
carecare
 Describe quality improvement cycleDescribe quality improvement cycle

42. Definition of quality
Quality is the degree of adherence to pre-Quality is the degree of adherence to pre-
established criteria or standards.established criteria or standards.
Is to do the right thing right at the first time inIs to do the right thing right at the first time in
the planed period.the planed period.

43. Criteria of quality in healthCriteria of quality in health
carecare
Appropriateness: refers to the balance between user's
needs and the capacity of the system from the technical
and materialistic aspects. (It is equivalent to functional
accessibility).
Accessibility: Four elements are important
1. Physical accessibility which means that the service is
located within reach of individuals walking or by using
transport.
2.Financial / economic accessibility is the affordability of the
cost of service.
3.Cultural accessibility is the acceptability of the service by
the clients.
4.Functional accessibility means that the right kind of care
is available to those who need it whenever they need it.

44. Effectiveness: refers to the degree to which
care is provided in correct manner to achieve the
desired outcome or how successful it was to
meet patient’s needs.
Equity: refers to fairness in dealing with the
clients.
Efficiency: refers to the best use of resources
to minimize cost and achieve cost containment.
Support to health care providers at all levels
they need economic and social support to
motivate good work.
Acceptability: A health care system should be
acceptable and attractive to its users.

45. Continuity: is the harmony and integrity of delivery of
care at different levels. Clients are provided with
comprehensive, integrated care, without
interruption.
Respect and Caring: The degree to which patients
are involved in the decision and the provider’s
reaction to the patient needs and expectations.
Competency: The degree to which practitioner
adheres to professional standards of care and
practice. It refers to skills and actual performance of
health providers
Safety: ensures minimizing risks of injury and harmful
side effects to health services delivery to patients
and also to health provider.

46. Steps for quality improvement
1. Develop a plan with SMART objectives for
improvement of service
2-Set standards which include: practice guidelines
administrative procedure, clear rules and
regulations
Specifications, distribution of responsibilities.
performance standards in relation to time and
resources
3-Communicate standards for the workers.
4-Monitoring of implementation; continuous
supervision.

47. 5-Identify problems, analyze each problem
to identify its root causes and put priorities
to these problems to be solved
6-Choosing a team to solve the problem
7. Develop solutions and actions for quality
improvement.
8.Implement and evaluate the quality
improvement efforts.
9-If succeeded repeat the cycle again in
another area.

48. HEALTH ECONOMICSHEALTH ECONOMICS
ObjectivesObjectives::
1.1. Define the major aspects of healthDefine the major aspects of health
economicseconomics
2.2. Describe financing mechanismsDescribe financing mechanisms
3.3. Understand cost-effectiveness analysisUnderstand cost-effectiveness analysis

49. Major aspects of Health
Economics
11--Financing Health CareFinancing Health Care
2-2- Cost analysisCost analysis
3- Cost effectiveness3- Cost effectiveness
4- Cost containment4- Cost containment

50. Causes of rise of health care
spending
- Demographic changes producing populations that
are older on average.
‑A changing pattern of disease towards chronic
illness.
‑Advances in medical technology and highly
sophisticated equipment.
-Rising public and professional expectations
connected with technological advances.
‑Increased utilization of curative health services
rather than self or community care.

51. -Higher wages and salaries.
‑Higher cost for drugs and supplies.
‑Lack of cost‑conscious behavior by providers.
‑Insurance coverage introducing a third party in the
health financing system (over-utilization &
increased cost).
-Inefficiency and inadequate management of
resources. Over stuffing, health workers are
badly deployed and supervised, hospital beds
are underutilized.

52. Examples of the public health activities thatExamples of the public health activities that
are highly cost-effectiveare highly cost-effective
ImmunizationImmunization : in the first year of life would have the: in the first year of life would have the
highest cost- effectiveness of any health measurehighest cost- effectiveness of any health measure
available in the world todayavailable in the world today..
School‑based health servicesSchool‑based health services , screening and, screening and
immunizationimmunization..
Health educationHealth education for family planning and nutritionfor family planning and nutrition..
Program to reduce tobacco & alcohol consumptionProgram to reduce tobacco & alcohol consumption..
for Aids preventionfor Aids prevention..
Primary health carePrimary health care is cost effective than building fiveis cost effective than building five
star hospitalstar hospital..
Head helmetsHead helmets to prevent complications of accidentsto prevent complications of accidents..

53. Measures for decreasingMeasures for decreasing
costscosts
1.Identify the most cost‑effective actions and
re‑orient the resources towards them.
2.Training of managers at all levels: Policy level,
top / middle management and health care
providers on rules of health economics.
3. More appropriate technology in the more costly
services and rationalized use of expensive
technology as MRI, CT scan.
4.Rationalized use of drugs.
5.The health insurance systems need to be
reformed for better use of resources.