Can you please help me with this Major Case Study? the subject is Health Services Administration

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Prepare a written answer to this situation and support your answer with sound reasoning.  Your answer should include at a minimum, the answers to the 10 questions stated below.  Your answer should be in a word document of no more than 10 -12 pages in length. 

A Country Case Study on the Partnership between Abu Dhabi and the Cleveland Clinic in the United States

  • Abu Dhabi is the capital of the United Arab Emirates, an oil- and gas-rich federation of seven Emirates.  All UAE nationals have a government-funded, mandatory health insurance provided by a public or private option.  Many of the acute care services in Abu Dhabi are oversubscribed and historically have had long waits.  Many Emiratis travel overseas to obtain access to world-class to health care; each year the government spends 25% of their health budget sending patients to other countries to obtain medical care.  To stem the flow of patients abroad, one of the government’s global targets is to create health care services that meet and exceed international standards.
  • The Mubadala Development Company PJSC (Mubadala) was established and is owned by the Government.  It partners with “best-of breed” international organizations, attracting world class experts to help diversify the economy in several business units including health care.  It has formed alliances with leading international health care organizations including Cleveland Clinic and Johns Hopkins Medicine International of the United States and Imperial College London.  In 2012 construction will be completed on Cleveland Clinic Abu Dhabi (CCAD), a state-of-the-art 364-bed multi-specialty hospital.  CCAD will attempt to replicate the culture and best practices of the Cleveland Clinic.  The organizational model will be Cleveland’s physician-led multi-specialty approach with a shared vision of achieving “outstanding patient experiences,” “superior clinical outcomes,” and “improved quality of life for the people.”

A Country Case Study on Canada’s High Quality, Low Cost Hernia Hospital

  • Shouldice hospital in Ontario, Canada, is an 89 bed hospital with five operating theatres that focuses on the surgical repair of simple inguinal hernias.  Shouldice is not only efficient but offers high quality care and attracts many medical tourists.  Whereas a general surgeon may perform 50 hernia repairs a year, each Shouldice surgeon performs over 600 per year.  What makes the clinical work challenging and rewarding for a Shouldice surgeon is repairing a hernia that another surgeon was unable to repair.
  • Shouldice is also a well-designed service proposition that has clinical value for a specific group of patients.  The care process includes a stay in a pleasant and relaxed environment, continuity of relationships, low prices, and high quality.  The physician-patient interaction differs from most surgical encounters; when patients are admitted, the first person they see is their surgeon who confirms their diagnosis, explains the procedure, and describes what to expect.  Once selected for Shouldice, patients are educated to become partners and co-producers in every aspect of the care process, which builds both trust and self-confidence.
  • Every patient, physician, nurse, and employee at Shouldice is an alumnus.  Patients, providers, and staff are fully engaged, understand their roles and responsibilities, and share an attitude and a mindset.  Through mutual interaction, learning and understanding, they are committed to the mission and goals of the clinical care process and adopt a Shouldice identity.  Value is created for patients, value is created for clinicians, and value is created for the organization.

A Country Case Study on Ethiopia’s Flooding and Retention Strategy

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  • Ethiopia suffers from an acute shortage of health workers at every level, and rural areas have been particularly chronically under-served.  It is estimated that 60% to 80% of the country’s health problems are due to largely preventable communicable diseases such as malaria, pneumonia, TB, and increasingly, HIV/AIDS.  Among the government’s health initiatives are the Health Extension Program (HEP) and the Ethiopia Public Health Training Initiative (EPHTI).
  • The HEP aims to improve primary health services in rural areas through an innovative community-based approach that focuses on prevention, healthy living, and basic curative care. It introduced a new cadre of health worker, Health Extension Workers (HEWs), and defined a package of essential interventions for them to deliver from village health posts.  Female high school graduates are recruited and trained for one year (candidates must have completed grade 10 in school, need to be from the local community, and speak the local language).  The program aims to train 30,000 new HEWs to work at local health posts.
  • The EPHTI is a partnership between the Ethiopian government ministries of Health and Education, The Carter Center, seven Ethiopian universities, and other nongovernmental organizations, that aims to improve the quality of pre-service training to health science professionals within Ethiopia and to build a team of qualified health care workers across the country, especially in under-served rural populations.  The program aims to train 5,000 health officers (the leaders of the community-based health centers’ professional staff) by 2010.  

A Country Case Study on Cuba’s Internationalist Principle and the Latin American Medical School Program

  • The devastation caused in Central America and the Caribbean by hurricanes George and Mitch led the Cuban government to offer medical assistance, to seek to strengthen local health systems, and to open a medical school in Cuba offering 10,000 scholarships to students from those countries.   This became the Comprehensive Health Program (CHP). 
  • The program’s underlying mission to train doctors to serve local communities by combining population-based public health principles and prevention with clinical medicine.  The focus of the training is bio-psycho-social; individual, family and community.  This prepares students well for working in resource poor settings where the close association between poverty and ill-health means that health professionals must have a good understanding to the economic, social, cultural and environmental determinants of health in order to be effective.  Health professionals must believe in health as a human right and must be prepared to make sacrifices to deliver on this right.
  • As well as this large scale training of doctors, Cuba also trained auxiliary personnel, such as nursing auxiliaries and health technicians, to serve in the rural areas and to meet the changing needs of the health system.  Cuba now has one of the best doctor to population ratios in the world and has better health indicators than countries that have substantially higher per capita spending on health.
  1. Make a convincing set of arguments in favor of the hypothesis that the world of health care is flattening.  What are the counter arguments?
  2. Why are most medical travelers from nearly every continent choosing Asia for their health care? Under what conditions would you consider going to another country to receive health care?
  3. Should governments take a position against the exploitation of organ donors, in particular, taking organs from prisoners or paid living donors?
  4. What international agency regulates unproven and/or experimental treatments? Who will ensure that evidence-based methods are used and comparative effectiveness studies are being conducted? Finally, do these providers who serve medical tourists have an institutional review board that oversees its medical ethics?
  5. Debate the following proposition—“DRGS are the most significant contribution to global health care management since World War II.”
  6. What explains the global price differential among hospitals? Why would countries like the U.S. have 10x the charges for procedures like hip replacements?
  7. Cleveland Clinic’s goal is to bring world class medical care to the people of the world wherever possible. Will it work? Will they attract medical tourists?
  8. 8. Are some professionals over-trained for the work that they do? Can we afford to continue training health professionals for periods of 5-10 years or is this now a luxury we can no longer afford? With increasingly sophisticated technological and medical diagnostic aids, how important is the human element in the process?
  9. 9. Why is there an insufficient supply of health professionals to meet current service demands? Should higher income countries follow Ethiopia and adopt shorter training, more specialized training, and task shifting to allied health professionals?
  10. 10. Are some professionals over-trained for the work that they do? Can we afford to continue training health professionals for periods of 5-10 years or is this now a luxury we can no longer afford? With increasingly sophisticated technological and medical diagnostic aids, how important is the human element in the process?

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