Hospital Management: Text & Cases

329 Pages·2013·2.385 MB·English

by  K. V. Ramani

Hospital Management
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Hospital Management
Text and Cases
K.V. Ramani
Professor
Centre for Management of Health Services
Indian Institute of Management, Ahmedabad
Copyright © 2013 Dorling Kindersley (India) Pvt. Ltd.
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ISBN 9788131794012
eISBN 9789332514089

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Contents
Preface xv
Acknowledgements xviii
About the Author xix
PART 1 IMPORTANCE OF HOSPITAL MANAGEMENT 1
1. Healthcare Industry 3
1.1 An Introduction 4
1.2 A Global View 4
1.2.1 Healthcare Industry 5
1.2.2 Pharmaceuticals 6
1.2.3 Medical Equipments 6
1.2.4 Biotechnology 6
1.2.5 Information Technology 6
1.2.6 Medical Tourism 7
1.3 The India Scenario 7
1.3.1 Healthcare Industry 7
1.3.2 Pharmaceuticals 7
1.3.3 Medical Equipments 8
1.3.4 Biotechnology 8
1.3.5 Medical Insurance 8
1.4 Health and National Economy 9
1.5 Health System Performance 19
1.6 Summary 25
Questions 25
References 26
2. Health Sector in India 29
2.1 An Introduction 30
2.2 Health Financing 30
vi Contents
2.2.1 Health Expenditure: Source of Funding 31
2.2.2 Health Expenditure: Service Providers 31
2.2.3 Public Health Expenditure 32
2.2.4 Private Health Expenditure 32
2.2.5 Health Expenditure by Function 34
2.3 Health Infrastructure 35
2.3.1 Public Health Infrastructure 36
2.3.2 Private Health Infrastructure 40
2.3.3 Public–Private Partnerships 41
2.4 Human Resources in Health 41
2.4.1 Demand for Health Workforce 41
2.4.2 Supply of Health Workforce 43
2.5 Role of Hospitals in the Health Sector 44
2.6 Summary 46
Questions 46
References 47
PART 2 HOSPITAL MANAGEMENT CHALLENGES 49
3. Hospital Management: Service Quality 51
3.1 An Introduction 52
3.2 Basic Concepts in Management 52
3.3 Hospital Management 56
3.3.1 Introduction to Hospital Management 56
3.3.2 Managing a Service Organization 57
3.4 Hospital Service Delivery 59
3.4.1 Issues and Challenges 59
3.4.2 Service Quality: Provider Perspective 62
3.4.3 Service Quality: Customer Perspective 63
3.4.4 Quality Control 64
3.4.4.1 Six Sigma Methodology 64
3.4.4.2 NABH 66
3.5 Hospital Queuing Systems 66
3.5.1 Simple Queuing Systems 66
3.5.2 Interdependent Queuing Systems 68
3.5.3 Computer Simulation 71
Contents vii
Mini Case 3.1: Star Hospital 72
Mini Case 3.2: A-One Surgical Hospital 74
3.6 Summary 78
Questions 79
References 80
4. Hospital Management Functions 82
4.1 An Introduction 83
4.2 Operations Management 83
4.2.1 Service Quality 84
4.2.2 Turnaround Time 85
4.2.3 Cost Reduction 85
4.2.4 Capacity Management 86
Mini Case 4.1: City Cardiac Hospital 86
Mini Case 4.2: Metropolitan Surgical
Hospital (A) 90
4.3 Finance and Cost Management 92
4.3.1 Finance Management 92
4.3.1.1 Balance Sheet 93
4.3.1.2 Profi t and Loss Statement 94
4.3.1.3 Cash Flow Statement 95
4.3.1.4 Financial Performance 95
4.3.2 Cost Management 98
4.3.2.1 Fixed Costs and Variable Costs 98
4.3.2.2 Direct Costs and Indirect Costs 98
4.3.2.3 Traditional Method of Cost
Allocation 100
4.3.2.4 Activity Based Costing
Methodology 100
4.3.3 Capital Budgeting: A Perspective 101
Mini Case 4.3: Metropolitan Surgical
Hospital (B) 103
4.4 HR Management 105
4.4.1 HR Planning and Development 106
4.4.2 Staffi ng 107
4.4.3 Work Systems Design 108
4.4.4 Reporting Relationships 109
Mini Case 4.4: Metropolitan Surgical
Hospital (C) 110
viii Contents
4.5 Materials Management 110
4.5.1 Purchase Management 111
4.5.2 Inventory Management 112
4.5.3 Stores Management 112
4.5.4 Pharmacy Management 113
Mini Case 4.5: Metropolitan Surgical
Hospital (D) 113
4.6 Summary 115
Questions 115
References 117
5. Hospital Management Support
Systems 120
5.1 An Introduction 121
5.2 Clinical Support 121
5.2.1 Clinical Lab Services 121
5.2.1.1 Total Testing Process 122
5.2.1.2 Lab Errors 124
5.2.1.3 Pre-analytical Phase 125
5.2.1.4 Analytical Phase 128
5.2.1.5 Post-analytical Phase 131
5.2.2 Radiology and Imaging Services 133
5.3 Information Support: Hospital MIS 134
5.3.1 Hospital Management Decisions 134
5.3.1.1 Policy Decisions 134
5.3.1.2 Strategic Planning Decisions 136
5.3.1.3 Operational Planning Decisions 138
5.3.1.4 Monitoring and Control
Decisions 139
5.3.2 Hospital Management Information System
(HMIS) 141
5.3.2.1 An MIS Perspective 141
5.3.2.2 Basic Characteristics of
Hospital MIS 143
5.4 Administrative Support Systems 148
5.4.1 Medical Records Management 148
5.4.2 Bio-medical Waste Management 148
5.4.3 Other Support Systems 150
Contents ix
5.5 Summary 151
Questions 151
References 152
PART 3 HOSPITAL MANAGEMENT CASE STUDIES 155
6. Hospital Operations Management 157
Case 6.1: CMC Hospital, Vellore (A) 158
Case 6.2: Majestic Hospitals 168
Case 6.3: ARAM Hospital (Apollo Group) 178
7. Hospital Finance and Cost
Management 190
Case 7.1: Apollo Hospitals 191
Case 7.2: City Municipal Hospital 208
8. Hospital Human Resource
Management 212
Case 8.1: CMC Hospital, Vellore (B) 213
Case 8.2: AMC Hospitals 226
Case 8.3: Bangalore Baptist Hospital (A) 234
9. Hospital Materials Management 248
Case 9.1: MPS Hospital 249
Case 9.2: MP Trust Hospital 257
10. Hospital MIS 266
Case 10.1: SJ Hospital 267
Case 10.2: Mahanagar Hospital 271
Case 10.3: RD Clinical Lab 282
PART 4 A FRAMEWORK FOR CASE ANALYSIS 289
11. Hospital Management Cases:
A Framework for Analysis 291
11.1 An Introduction 292
11.2 Patient Health Management 292