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Health Administration

Spring 2012
Master of Business Administration – Semester 3
MH0051: “Health Administration”
ASSIGNMENT- Set 1 Marks 60
Note: Each Question carries 10 marks. Answer all the questions.

1. Discuss the healthcare delivery system in India.
In India health care delivery and medical education are largely governmental functions. India cannot afford a national health service. However, it has a national health policy based on the primary health care approach, with emphasis on rural health in order to achieve the World Health Organization’s goal of “Health for All” by 2000 AD. Health care delivery is represented by the public sector as well as the private sector. Nearly 80% of the health facilities, both public and private, are concentrated in the urban areas. Hence despite its best efforts, the government has not been able to make medical education need-based. The postgraduate surgical trainees are not exposed to rural work owing to inadequate facilities and resources in rural areas. Surgical residents get their training in teaching hospitals located in urban areas. Most of the public sector teaching hospitals as well equipped to impact training to the residents according to the guidelines of the Medical Council of India (MCI), the apex governing body. However, the rapid advancement in medical technology over the last decade, the government is finding it increasingly difficult to keep these teaching hospitals up-to-date. Of late, some of the sophisticated private sector hospitals are therefore sharing the onus of surgical education, especially at the subspeciality level. Thus despite the good intentions of government planning a two class system of health care delivery has come into being and a two class system of medical education is foreseeable.
What is the current position then? Lots of changes have occurred already and healthcare has become a part of consumerism largely and is minus commitment. Though this transformation is highly detestable, this is a part of the evolution perhaps. All these new notions have made the healthcare delivery system extremely complicated and even India, the land of Charaka, is no exception. Are you familiar with the name of Charaka? Charaka was one of the principal contributors to the ancient art and science of Ayurveda, a system of medicine and lifestyle thought to be developed about 5000 years ago in Ancient India. The same discipline has mesmerized and benefited millions of people across the world so far.

If you are having any remorse, I am too sorry for that. Nevertheless, there is no other way and let’s proceed and concentrate on the delivery system of modern worldwide healthcare industry. However, it must be remembered from the onset that a patient has been transformed into a healthcare consumer. Nowdays, in many countries, especially in the United States of America, a number of private insurance companies have emerged with lots of insurance plans. These insurance plans are regarded as part and parcel of healthcare delivery system and are found to have open access networks that enable members to go in and out of network to obtain essential care.

However there are other problems as well. What are they? It’s true that the new scenario has brought to the fore a huge number of specialists, facilities and services but there have also been the appearance of splintered or disjointed packages and these are looked after and supported at various centers instead of a centrally administered unit.

Nonetheless the situation in Illinois, the leading midwestern state in north-central United States, is quite different. In the state it is possible for any healthcare consumer to have a total package and to except a unique blend of technology and personal touches as well. What are their main objectives therefore? They, it has been learnt, are on the lookout for healthcare systems that are recognized on a national scale for specialty programs like heart care, obstetrics, trauma, oncology, rehabilitation, geriatrics, Chicago occupational health, treatment of alcohol and chemical dependency and psychiatric services. It has also been witnessed that they do want access to the best 10 hospitals in the state of Illinois which are known for proficiency or expertise.

This is becoming possible owing to the presence of many centers including Riverside Medical Center, the well-known not-for-profit medical facility. It provides access to its hospitals that are ranked in the top 10 hospitals in Illinois and proffers the best expertise regarding Chicago occupational health services and healthcare.
2. Which are the main steps in planning and management of health care?
3. What would you state about the current scenario of Health Status in India?

4. How investigation of an epidemic is helpful in treatment and prevention of a disease?
5. Explain the mortality profile of India.
6. Discuss the significance and achievements of the National Programs on communicable diseases

Spring 2012
Master of Business Administration – Semester 3
MH0051: “Health Administration”
ASSIGNMENT- Set 2 Marks 60
Note: Each Question carries 10 marks

1. Why national health program on maternal and child health is necessary?
To reduce infant mortality, this program provides access to comprehensive prenatal and postnatal care for women; increases the number of children receiving health assessments and follow-up diagnostics and treatment; and provides access to preventive care (including immunizations) and rehabilitative services for children. States must spend 30 percent of their funding on children with special health care needs; 30 percent also must be spent on primary and preventive care for children.
This grant program supports federal and state partnerships that provide gap-filling maternal health services to more than 2.6 million women, and primary and preventive care to more than 27.8 million infants and children, including approximately 1 million children with special health care needs.
HRSA also administers the Maternal and Child Health Block Grant set-aside programs of SPRANS and CISS.
SPRANS projects support research and training, genetics services and newborn screening, and treatments for sickle cell disease and hemophilia. CISS projects seek to increase local service delivery capacity and foster comprehensive, integrated, community service systems for mothers and children.

HRSA’s Maternal and Child Health Bureau administers programs that serve more than 34 million women, infants and children each year. About 60 percent of U.S. women who give birth receive services through HRSA-supported programs.
– Most MCHB funds are sent to states through formula-based block grants, which totaled $551 million in FY 2008. These block grants support vital immunizations and newborn screening tests, along with transportation and case management services that help families access care. States also use block grant funds to develop and implement community-based care systems for children with special health needs and their families.
– Additionally, HRSA supports 102 Healthy Start sites in 38 states, the District of Columbia, and Puerto Rico that provide community-based outreach, case management, depression screening and educational activities for women in areas with high rates of infant mortality and shortages of health care providers.
– HRSA also collects survey data on the physical, behavioral and emotional health of women and children nationwide. In addition, HRSA publishes and disseminates the Women’s Health and Child Health USA databooks.
The National Healthy Start Association (NHSA) is an advocacy and networking group for Healthy Start programs. The mission of the National Healthy Start Association is to promote the development of community-based maternal and child health programs, particularly those addressing the issues of infant mortality, low birthweight and racial disparities in perinatal outcomes.

As part of its mission, the NHSA supports the expansion of a wide range of activities and efforts that are rooted in the community and actively involve community residents in their design and implementation. – Educate its members, the public at large, federal, state and local policymakers and elected officials on the need for and effectiveness of community-based programs to reduce infant mortality, low birthweight, and racial disparities in perinatal outcomes. – Provide a nationwide communications and technical assistance network for the exchange and dissemination of “models that work.” – Increase public awareness concerning the needs of pregnant women, infants, children and families. – Identify common factors that impact maternal and child health status and develop strategies to sustain Healthy Start and other community-based maternal and child health programs. – Collect and analyze data and publish reports on evaluation findings and lessons learned from Healthy Start programs.

Healthy Start programs rely on standards set by Healthy Families America. HFA is based upon a set of critical program elements, defined by more than 20 years of research. Over the past several years, states across the country have embraced the critical elements of HFA and are working toward implementing statewide home visitation policies and programs. The critical elements represent the field’s most current knowledge about how to implement successful home visitation programs.

All affiliated and credentialed HFA programs adhere to these critical elements which provide the framework for program development and implementation. Staff are trained on the critical elements. Programs are credentialed based on adherence to the critical elements. In addition to helping assure quality, the critical elements allow for flexibility in service implementation to permit integration into a wide range of communities and provide opportunities for innovation.
The following are descriptions of each critical element.

2. What do you mean by behavioural health? Why is behavioural health important in community?

3. Name occupational diseases most prevalent in work places and their prevention methods.

4. What are the steps in disaster management planning and implementation?

5. Explain the meaning and concept of health Insurance.

6. What are International Health Regulations and why are they important?

Spring 2012
Master of Business Administration – Semester 3
MH0052: “Hospital Organization, Operations & Planning”
ASSIGNMENT- Set 1 Marks 60
Note: Each Question carries 10 marks. Answer all the questions.

1. Classify hospitals based on objectives, ownership and size.
It is absolutely essential to increase the level of efficiency for the development and prosperity of an organization. The hospitals, having accepted the responsibility of serving the social interests need to focus on the acceleration of productivity because; cost effectiveness is a must to make the services economical and affordable to the masses.
The hospital administrators bear the responsibility of hospital organization and departmentation because they are supposed to accelerate the pace of development. Although the top management takes policy decisions related to the hospital organization and departmentation, the functional responsibilities are discharged by the administrator and his team of managers.
The main objective of the hospital organization is “care of sick” or “good patient care” for which medical and its support services are very significant. It is not possible for a single department to take care of the medical services, nursing services, radiology and lab services. The concept of departmentation was to improve the “quality of service” and improve the level of efficiency.
There are different classifications of a hospital, based on objectives; size of hospital; system of medicine followed; level of care provided; nature of ownership and revenue generation.
1. Based on objectives the hospital may be classified as:
— General hospital
— Specialty hospital
— Teaching and research institute
2. Based on the system of medicine followed:
— Allopathy i.e. English medicine
— Ayurveda
— Homeopathy
— Naturopathy
— Unani
— Multi system i.e. hospitals which follow combinations of various systems of medicine
3. Based on the size:
— Small sized hospital i.e. bed capacity of about 100 beds
— Medium sized hospital i.e. bed capacity ranging from 100-300 beds
— Large sized hospital i.e. above 500 beds
4. Based on revenue generation:
— Not- for- profit hospitals i.e. those run by voluntary organizations
— Free hospitals i.e. where charges are not levied for services provided
— For- profit hospitals
5. Based on the ownership:
— Government /public hospitals
— Semi- government hospitals
— Voluntary/ Trust hospitals
— Corporate hospitals
— Private hospitals
— Charitable hospitals
6. Based on location:
— Village/panchayat hospitals
— Town hospitals
— City/metro hospitals
7. Based on the level of care provided:
— Primary care
— Secondary care
— Tertiary care

2. What are the managerial skills to be possessed by a health services manager?
3. Write a note on components of patient care areas.

4. Outline the planning considerations required in setting up an accident and emergency department. Add a note on its importance.

5. Write in brief on the design considerations of the intensive care unit.

6. Enumerate the various activities of the central billing department.
Spring 2012
Master of Business Administration – Semester 3
MH0052: “Hospital Organization, Operations & Planning”
ASSIGNMENT- Set 2 Marks 60
Note: Each Question carries 10 marks

1. Enumerate the policies and procedures adopted in a medical records department. Add a note on its importance.
Consider hiring a consultant with expertise in creating and evaluating policies and procedures for nonprofit organizations similar to yours (see Resources).
Find templates for policies and procedures that can be customized for your organization if you prefer not to hire a consultant (see Resources).
Review organizational issues with staff and the board of directors. Policies and procedures need to answer potential questions put forth by any stakeholder in the organization. Questions regarding such items as travel policies, mileage and communication with the public are all items that everyone involved will need to know.
Include human resource, volunteer management and consumer issues. Nonprofits often serve underserved members of society, making it paramount that policies and procedures address the nature in which the organization operate with minorities or underserved populations.
Determine the issues that face the industry. Nonprofits address a variety of concerns in the community. One organization may address problem youth while another may seek to support battered women. It’s important to know legislation and current issues surrounding these groups and to customize policies and procedures accordingly.
Join online message boards where issues facing the organization are discussed to stay current on related issues.
Schedule a retreat with the executive director, senior management and stakeholder in the community. Brainstorm on policy and procedure best practices during this retreat. Combining this final step with all the previous steps will ensure that the final policy and procedure manual for the nonprofit organization will be comprehensive and meet the needs of all potential stakeholders.

2. Write in brief note on the laboratory services.

3. Enumerate the functions of the dietary department. Add a note on its importance.
Importance of the dietary service:

4. Explain the importance of housekeeping services in the hospital.

5. Why is quality the most important principle of material management?

6. What can material manager do as to management of life-saving drugs?
Winter/November 2011
Master of Business Administration in Healthcare Services Semester 3
MH0053 — Hospital and Healthcare Information Management (4 Credits)
Assignment Set- 1 (Marks 60)

Q.1.Discuss the various functions performed by Health information professional
Health information management (HIM) is the practice of maintenance and care of health records by traditional (paper-based) and electronic means in hospitals, physician’s office clinics, health departments, health insurance companies, and other facilities that provide health care or maintenance of health records. With the widespread computerization of health records and other information sources, including hospital administration functions and health human resources information, health informatics and health information technology are being increasingly utilized in information management practices in the health care sector.
Health information management professionals plan information systems, develop health policy, and identify current and future information needs. In addition, they may apply the science of informatics to the collection, storage, use, and transmission of information to meet the legal, professional, ethical and administrative records-keeping requirements of health care delivery. They work with clinical, epidemiological, demographic, financial, reference, and coded healthcare data.
It has been suggested the proper collection, management and use of information within healthcare systems “will determine the system’s effectiveness in detecting health problems, defining priorities, identifying innovative solutions and allocating resources to improve health outcomes.” For example, health information administrators have been described to “play a critical role in the delivery of healthcare in the United States through their focus on the collection, maintenance and use of quality data to support the information-intensive and information-reliant healthcare system”. As the field grows and information technology becomes a more crucial part of the medical world, health information management is experiencing a transition from traditional managing practices with paper to more efficient electronic management, such as with Electronic Health Records (EHRs). But the main goal is still to analyze, manage, and utilize the information that is essential to patient care and making sure the providers can access the information when necessary
The hospital administrator must clearly define the duties and responsibilities of Health Information Administrator (HIA) and the policies under which his department will operate. He should keep the HIA informed of goals, policies, and current programs of the hospital. He must delegate sufficient authority to enable the HIA to carry out his responsibilities. In addition, the administrator must provide sufficient personnel to enable the HIA to carry out the duties of the department effectively. The administrator must also provide adequate facilities and equipment to meet departmental objectives. He must support the efforts of the HIA to maintain the standards set for his department, and he must encourage him to keep abreast of the latest developments in the medical record field by attending educational and professional meetings.
Medical Staff
Work in hospital is highly specialized and requires a great deal of interaction among health professionals. Much of the work of the hospital is performed by highly trained professionals, the physicians, who require the collaboration, assistance and services of many associated health professional and non-professional personnel. The medical staff is made up of physicians who are permitted to send their patients to the hospital for admission. Members of the attending staff agree to assume certain responsibilities, such as committee assignments and attending medical staff meetings. In return they have a vote and a voice in establishing policies relating to medical care in the hospital.
The medical staff is organized as self-governing group with bylaws, clinical departments and committees. The health information administrator plays an important role in promoting the continuing smooth functioning of medical staff activities. He provides medical statistical information and stimulates research from the medical records. He frequently assists the medical staff in planning the selection of data for studies, and suggests unusual cases for presentation at staff meetings.
The health information committee serves as the liaison between the health information department and the medical staff. It is the responsibility of the health information committee to see that accurate and complete medical records are secured for every patient treated. The HI administrator attends the meetings of the health information committee and gives professional advice if called upon to do so by the committee members. Committees of the medical staff that closely interact with the health information department include: health information committee, utilization review committee, committees involved in medical evaluation, infection committee

Q.2. Write short notes on Goals of HMIS

Q.3. Discuss the functions of radiology department
Q.4. Mr. Lokesh after completing his MBA HCS course, got job as a health information officer in Medical trust hospital in Ernakulum, Kerala.

Q5.Write short notes on role of nurses in system development Life Cycle

Q6. Explain and describe
(a) CBHI
(b) SRS 




E-health is abbreviated from Electronic-health. E-health basically means use of electronic communication and information technology in the health sector wherein digital form of data is stored and retrieved electronically-for various purposes like clinical, educational and administrative, both in local areas as well as at a distance.

The word E-health comprises of telehealth, telemedicine, m-health and other health IT components, which are covered in detail in the subsequent sections. In cases where speed is vital in delivering healthcare services, E-health can be used. Suppose a natural disaster has struck some location, E-health can be used to save many lives. Internet and video conferencing is a familiar concept to most of us. E-health provides healthcare using these concepts. Therefore, healthcare services can be provided electronically to areas where natural calamities have struck. E-health has been adopted worldwide. It has made considerable amount of progress in India as well.

Definition of E-health

E-health is defined as the use of communication and information technology in the field of medicine. Transfer of medical records or other related data takes place through electronic processes. It also enables two professionals at different geographical locations to interact with each other.

E-health is a relatively new term introduced in medical science. The concept of E-health is supported by electronic and communication technology. The term covers a wide range of medical and healthcare services like telemedicine and m-health. Some say that E-health is interchangeable with healthcare informatics and is a sub set of health informatics. Few others use it in the narrow sense as using Internet in healthcare practice. E-health covers more than just Internet and medicine.

Introduction to E-health







Spring / February 2012
Master of Business Administration- MBA Semester 3
MH0054 — Finance, Economics & Materials Management in Healthcare Services – 4 Credits
Assignment Set- 1 (60 Marks)
Note: Each Question carries 10 marks. Answer all the questions.

Q1. Elucidate upon the significance of financial information in the field of Decision-making in healthcare organisation.
Today hospitals need financial information systems that could be rolled out at each institution not only improved overall efficiencies, but also provided the flexibility necessary to support future growth. The major function of financial information is to oil the Decision-making process. Figure 2.1 shows how it happens.
In Figure 2.1, the hospital authorities make use of the information provided by the financial statements, in this case, financial forecast of a proposed Ambulatory Surgical Center (ASC). On the basis of this information, the authorities can decide whether or not, it will be feasible to develop the ASC. The next step is the implementation of the decision. Let us suppose that in this case, the authorities decide to go ahead with the ASC. As a result to it, the organisation incurs losses. How did the authorities come to know about these losses? Obviously through the financial information disseminated. And how do the organisation decide about the next step? Gain the same method. By looking into the financial information, the authorities can analyse the problem areas for revenue and can either improve ASC’s financial performance in the next year or continue to bear the losses (only if they seem to be inevitable for some initial years) or do away with the center.
Healthcare organisations are quite similar to most large business corporations. Running them efficiently means putting in place of a Financial Information System (FIS) that operates effectively on all levels, from individual departments to the corporate office. When an organisation grows, coordinating these systems across the enterprise is crucial.
The problem in healthcare, however, is that many of the groups have a centralised corporate office and the hospitals running under it are situated miles apart. This creates a world of disparate systems that require interfacing with other hospital systems. This can be a daunting task within a single hospital, let alone among a dozen facilities owned or operated by a parent company.
In healthcare organisations, budgeting, cost accounting, strategic planning, and financial and clinical analytics are disconnected functions, performed on different systems and with varying data. This makes reporting actual results against the budget, operations and strategic plan all but impossible, and fails to take into account key factors in an organisation’s true financial performance.
But things are beginning to change. Large healthcare organisations, and some vendors, have realized that financial information systems can no longer be relegated to back-office status. Their importance in patient billing, claims processing, materials management and even strategic planning requires that standardized business applications be accessible to key personnel across the entire enterprise, whether that means one hospital or a dozen.

Q2. Direct payments bring a range of tangible benefits. Discuss.
Q3. Explain the various steps involved in the process of joint products costing.
Q4. Explain the meaning of tax. What are the different methods of managing taxes?
Q5. “Uncertainty makes it difficult for a financial manager to predict the company’s requirements for short-term funds”. Discuss. What steps can the financial manager take to minimize the resulting risks to the company?
Q6. Explain the budgeting process for healthcare services.

Spring / February 2012
Master of Business Administration- MBA Semester 3
MH0054 — Finance, Economics & Materials Management in Healthcare Services – 4 Credits
(Book ID: B1215)
Assignment Set- 2 (60 Marks)
Note: Each Question carries 10 marks. Answer all the questions.
Q1. Discuss the role of economics and economists in healthcare.
Economics is concerned with the allocation of scarce resources among their competing uses, on the face of unlimited and insatiate human wants. Among these wants are health care services for which we cannot use exactly the same Economic Principles we use for other goods and services; because they have special characteristics that make them different than the others. That is why a special branch of economics is developed to deal with them called “Health Care Economics”.

1- Definition:

Health Care Economics is a new branch of Economics concerned with how to apply the Economics Tools for heath care issues and explain its different aspects to make them more analyzable. It also offers measures to determine if a certain policy will increase or decrease the economic efficiency and the equitable distribution of health care services. Of course, economic analysis cannot help in all the concerns of health professionals and the general public in the area of health care services. Different problems need different training and experiences. The particular problems suitable for economic analysis are those related to scarcity of resources. In this respect, economics can explain the most preferable choices of the society when its available resources are not enough to satisfy all its needs. That is usually the case in all societies because of the strong competition between the different needs of each society such as education, health care, security, defense, roads, ….ect.

2- Economics Tools:

Q2. Explain different methods of evaluation of healthcare services.
Q3. Why is the private healthcare sector an attractive destination for investors? What are the ways to invest in this sector?
Q4. Discuss the method of price determination under oligopoly.
Q5. What are the things that should be kept in mind before and while conducting an economic evaluation of healthcare services? Discuss in brief.

Q6. What do you mean by healthcare planning? What issues are highlighted in healthcare planning in India?

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