health Management
Health management is the systematic organization of more or less complex socio-political measures and institutions for the purpose of maintaining and promoting the health of the population.
Basics
Health management includes a variety of tasks and functions for organizing health , especially in the form of health promotion . It is based on a biopsychosocial understanding of health. The aim is to strengthen health coping processes such as needs-based care. Health management is implemented in health and social policy institutions , such as the self-help group through welfare care to the institutions of health, accident and pension insurance, known under the term social security . Second, tasks are described such as the planning, organization, control, regulation and evaluation of health-related services (cf. Niehoff, J.-U., Braun, B., 2003, p. 107).
Methodologically, health management is a cross-sectional subject, integrates several disciplines such as social medicine , health economics , medical law and medical sociology and is systematically part of the health sciences , especially in the form of "New Public Health " (cf. Mann, B., 2005; Waller, H., 2002 ). In the context of the health goals of the World Health Organization (WHO), health management is a strategic approach of "health for all" . As a company health management system , this health-related approach has been further developed scientifically and practically.
Management approaches
Schwartz and Wismar (1998, pp. 560-564) speak of four basic management orientations; they are rooted in the concept of goal-oriented management ( Management by Objectives ):
- population or community-based
- provider-oriented
- patient, client and consumer oriented
- system-oriented
Population or community based
This is a "classic European approach to the organization of the health system" (cf. Schwartz / Wismar, 1998, p. 561) against the background of the idea of population-wide care. In Great Britain the National Health Service should be mentioned as an example , in Germany the statutory health insurance with an insurance rate of approx. 89%. Traditionally local or regional references can also be found in Sweden .
Provider-oriented
Provider-oriented management concepts relate to requirements planning and security on the provider side, e.g. B. by hospitals and other health facilities (see Goldschmidt AJW / Hilbert J, 2011), human resources management with the question of the function and management of human labor in institutions of the health care system and technology planning (see Schwartz / Wismar, 1998 , P. 562). A distinction is made between instrumental and real health needs . The instrumental need refers to available means of treatment, such as outpatient care, inpatient care, beds or doctors. The real need can include more complex supply services such as health promotion at the workplace ( company health promotion ) or at schools (e.g. healthy living, learning ), traffic calming, environmental protection or social workers in medical practices (see ibid.).
Patient and consumer oriented
Defining patient needs consistently is difficult because it is about subjective patient needs. In general, however, it can be stated that the necessity is seen for patients to have the opportunity to enforce their rights. According to Schwartz and Wismar, patient orientation is only just beginning in the German-language literature on health management - unlike in the USA (p. 563). Internationally, patient orientation is discussed on three levels (ibid):
- Patient-oriented quality management
- Management of service
- Consumerism approach
The focus of patient- oriented quality management are the health-specific “customer” needs, as discussed under the Total Quality Management approach ( TQM ). Service management analyzes health care as part of a service economy. The consumerism approach is based on the controversial discussion of consumer sovereignty on the part of the patient, especially since the choice between different services in the healthcare system is subject to considerable restrictions (p. 564).
System oriented
The background for this view is the connection between a growing need for care and increasing financing problems. This connection is interpreted as a "system-dependent control problem in health care" (cf. Schwartz / Wismar, p. 25). This financing orientation has gained in importance in most industrial health systems. An "outcome-oriented target discussion" can also be observed at the system level. It is based on the actual health results for patients and population groups.
Qualifications
The core competencies relate firstly to the analysis of historical, sociological and economic dimensions of health security. Here, the gains Social security , including the conflicts in this system is very important. Second, further core competencies include the social ability to be familiar with the interests and problems of health-related services. Because the justification and evaluation of future options for the systemic and economic design of health services is an important goal.
In addition to the core competencies, further skills are shown (see Niehoff, Braun, 2003, p. 107):
- conceptual and organizational skills
- social competence in the management of personal services
- Mastery of personnel and business processes
- Knowledge of the legal basis
Degree programs and degrees
Degrees or job titles in health management can be acquired as an additional qualification or through an undergraduate degree. Often there is an economics postgraduate course accompanying the medical profession . Depending on the scope and previous education, the degree is awarded with a certificate or an academic degree such as a bachelor's or master's degree.
literature
- Ralf Brand: Sports psychological interventions and health behavior. Saarbrücken 2008, ISBN 978-3-8364-5615-9 .
- Andreas JW Goldschmidt , J. Hilbert (Hrsg.): Hospital management with a future. Thieme, Stuttgart 2011, ISBN 978-3-13-161231-1 .
- Stefan Hoffmann, Stefan Müller (eds.): Health marketing: Health psychology and prevention . Hans Huber, Bern 2010, ISBN 978-3-456-84801-3 .
- Michael Kastner (Ed.): Performance and health management - psychological stress and aging, content and economic evaluation . Pabst, Lengerich / Berlin 2010, ISBN 978-3-89967-657-0 .
- Bernhard Mann : Health and Society . In: Social Sciences and Professional Practice. (SuB), Vol. 28 (2005) Issue 1, ISSN 0724-3464 , pp. 120-128.
- Jens-Uwe Niehoff: Health security - health care - health management. Basics, goals, tasks, perspectives. 1st edition. Medical Scientific Publishing Company, Berlin 2008, ISBN 978-3-939069-48-5 .
- Jens-Uwe Niehoff, Bernard Braun: Social Medicine and Public Health . 1st edition. Nomos Verlagsgesellschaft, Baden-Baden 2003, ISBN 3-8329-0118-3 .
- FW Schwartz , B. Badura , R. Leidl, H. Raspe , J. Siegrist (Eds.): The Public Health Book. Health and healthcare . 1st edition. Urban & Schwarzenberg, Munich / Vienna / Baltimore 1998, ISBN 3-541-17441-2 .
- Heiko Waller : Social Medicine . 5th edition. Kohlhammer, Stuttgart 2002, ISBN 3-17-017015-5 .