Course Syllabus

Health Delivery and Prioritization A

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Semester & Location:

Spring 2019 - DIS Copenhagen

Type & Credits:

Core Course - 3 credits

Core Course Study Tours:

Western Denmark and Tallinn-Helsinki

Major Disciplines:

Pre-Medicine/Health Science, Public Health, Public Policy

Faculty Member:

Louise Bagger Iversen and Maria Zabell 

Program Director:

Susana Dietrich

Time & Place:

Mondays and Thursdays, 8:30 – 9:50, V10-D14

Faculty

DIS-Academics-Louise-Bagger-Iversen.jpg

Louise Bagger Iversen

M.Sc. and B.Sc. Public Health (University of Copenhagen, 2011/2007). Consultant in the Planning Department (Quality and Development, Region Sjælland, 2011-2014). Board member of the Danish Association for Public Health Science (2015-present). Assistant Program Director at DIS since 2014.

Public-Health-Maria-Zabell.jpg

Maria Zabell 

M.Sc. Public Health (University of Southern Denmark, 2016), B.A. in Nursing (University College Absalon, 2013), Research Assistant (Odense University Hospital, February-May 2017), Nurse (Neonatal ward, Rigshospitalet, 2016-2017), Research and project manager (WoMena, 2016-present). With DIS since 2018.

 

Course Description

Different countries choose different approaches to the provision of healthcare. Through this course, you will gain insight into how healthcare is organized and financed in Denmark and Northern Europe, and you will investigate the impact of the social, economic, and political history on the present systems.  You will analyze principles of priority-setting in health care, and discuss and assess possible solutions to challenges such as aging populations, inequality in health, and rising healthcare expenditures.

 

Expected Learning Outcomes

After successful completion of this course, you will be able to:

  • Understand the organization and financing of the Danish healthcare system and know its key stakeholders
  • Analyze and compare health systems across countries
  • Explain, compare, and discuss different ways of prioritizing in healthcare
  • Explain and examine determinants of inequality in health and discuss measures to reduce inequality

 

 After successfully completing the Public Health Semester Group Project, you will be able to:

  • Frame and design a research question
  • Search, select, and study a number of relevant sources and apply them to your research question
  • Write a structured paper that contains a critical and comparative analysis and discussion of a specific topic of relevance to the course focus
  • Present your results and conclusions to an audience in a scientific and engaging manner

 

Teaching Methods

The course will be a mix of interactive lectures, class discussions, group work, student presentations, and feedback sessions. While we as faculty are responsible for the overall structure of the class, all of us will contribute to the production of knowledge. All students are expected and encouraged to engage actively in class sessions.

 

Evaluation and Grading

To be eligible for a passing grade in this class, all of the assigned work must be completed. The factors influencing the final grade and the proportional importance of each factor is shown below:

Component Weight
Participation 15%
2 Tests (25% each)
50%
Study Tour Assignment 10%
Semester Project 
25%

 

A word about grades: we realize that grades are important to you, but try not to let your anxiety about grades deter you from taking intellectual risks and learning just for the joy of learning. Also, we do not grade to punish or reward you, just as our grade is not an indication of our evaluation of you as a person. We grade you to give you our honest assessment of your academic performance at this point in time.

Below you can read more about the individual components.

 

Class Participation

This is intended to be an interactive class. Primarily because it provides for a better learning experience, but also because it makes classes more fun. In order to participate, students are required to attend all classes, read and prepare before each class, and to participate actively in class.

Study Tour Participation

Before both study tours you will be provided with information and links about the academic visits on the tour. During the tour it is important that all students participate and show interest and enthusiasm – whether it’s a course specific or a cultural visit. The more active participation from students, the better the learning experience for everyone.

Tests

Each of the two test consists of a section with a mix of multiple choice, short-answer, fill-in-the-blank(s)/handout questions, and a section with a 300 words essay-question.

 The second test will only cover class material from the first test and onward. No notes, books, internet etc. are allowed.

    Please be aware that the tests will be a mix of typed and hand-written, so please bring a computer.

     

    Study Tour Assignment

    This assignment consists of 1) two Tumblr posts and 2) a group presentation following the short and long study tour.

    1. Two Tumblr posts: During tours, you will upload a group post from CCW and a group post from long study tour to the Tumblr account for this course
    2. Group presentation: in the Tumblr groups, students will create a 12-15 minute presentation based on their impression from their assigned visits on short and long tour

    More information is given in class but please note that this assignment will be graded according to group performance and not individual performance. 

    Semester Project

    In groups, students will choose between a number of course specific topics given by the instructor. Within the given topic, the groups will phrase and investigate a research question of their own choice.

    The project paper is the core of the semester project. The paper will be handed in twice. First as a draft version for feedback and secondly as a final version.

    On Canvas, you will find a separate document that describes the semester project in more detail. In class, we will discuss how to write the project paper.

    More information is given in class but please note that this assignment will be graded according to group performance and not individual performance. 

     

    Core Course Week and Study Tours

    Core Course Week and study tours are an integral part of the core course.  We take the classroom on the road and see how theory presented in the classroom translates into practice in the field. You will travel with your classmates and DIS faculty/staff on two study tours: a short study tour in Denmark during Core Course Week and a Long Study Tour to Tallinn and Helsinki.

    Expectations for study tours:

    • Participate in all activities
    • Engage in discussions, ask questions, and contribute to achieving the learning objectives
    • Respect the destination, the speakers, DIS staff, and your fellow classmates
    • Represent yourself, your home university, and DIS in a positive light

    While on a program study tour, DIS will provide transportation to/from the destination(s), accommodation, approx. 2 meals per day, and entrances, guides, and visits relevant to your area of study or the destination. You will receive a more detailed itinerary prior to departure.

    Travel policies: You are required to travel with your group to the destination. If you wish to deviate from the group travel plans on the way back, you need approval from the assistant program director. Please see specific travel dates in the course schedule below.

     

    Policies

    Attendance

    You are expected to attend all DIS classes and activities when scheduled, and we will actively monitor attendance. Absences will jeopardize your grade and your standing at DIS. Excused absences include only serious illness and participation in religious holidays.

    If you miss multiple classes, the Director of Academic Support, and the Director of Student Affairs will be notified and they will follow-up with you to make sure that all is well. In the case of multiple absences, you will need to provide a doctor’s note.

    Missing class: You must always notify your instructor about an absence a reasonable time in advance. Each failure to notify your faculty of an absence in advance will result in a deduction of 2 points off your final participation grade.

     

    Class room etiquette

    A good learning environment requires that everyone is present, prepared, and participating. Out of respect for both faculty and fellow students, we expect you to be on time and to participate in the full duration of the class.

    Laptops and phones in class: You may use your laptop for note‐taking or fact‐checking. Usage of laptops or phones not related to the class is unacceptable, and will reduce your participation grade significantly.

    Make-up classes: There are a few open slots for make-up classes in the syllabus. Please note that there may be organized mandatory classes during these time slots.

    Assignments

    Assignments and tests are submitted via Canvas. Submissions exceeding the word limit will be penalized by a third of a grade per additional page or part thereof (A- becomes B+, B becomes B- etc.).

    Late assignments will be accepted, but your grade will be reduced by 2 thirds of a grade for each day or part thereof that it is late (A- becomes B, B becomes C+ etc.).

     

     Academic Regulations  

    Please make sure to read the Academic Regulations on the DIS website. There you will find regulations on:

    DIS Contacts

    Tatyana Louis, Program Assistant, tlo@dis.dk 
    Louise Iversen, Assistant Program Director, lbi@dis.dk
    Susana Dietrich, Science & Health Program Director
    Science & Health Office: Vestergade 7-37

      

    Required Readings

    1. Arcaya MC, Arcaya AL, Subramanian SV (2015). Inequalities in health: definitions, concepts and theories. Glob Health Action 8: 8: 27106. Please focus on the following pages: (page 1-6 (stop at "geographic..."), page 9-10 (from "explaining health inequalities”). Rest of paper is optional.

    2. Donaldson C, Gerard K (2005). Economics of Health Care Financing: The Visible Hand. Basingstoke: Palgrave Macmillan. P. 35-38

    3. Esping-Andersen G (1990). The Three Worlds of Welfare Capitalism. New Jersey: Princeton University Press: pp. 18-29.

    4. Goroll AH. (2015). Toward Trusting Therapeutic Relationships - I Favor of the Annual Physical. NEJM 373;16;1487-1489.

    5. Health Consumer Powerhouse (2017). European Health Consumer Index. Report 2017. Pp. 6-21.
    6. Krasnik A et al. (1990). Practice Observed: Changing Remuneration Systems: Effects on Activity in General Practice. BMJ, 300:1698-1701.

    7. Krogsbøll et al. (2012). General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis. BMJ 345:e7191:1-13.

    8. Lai T, Habicht T, Kahur K, Reinap M, Kiivet R, van Ginneken, E (2013). Estonia: Health System Review. Health Systems in Transition, 15(6). Read: Executive Summary: xvii-xxiii.

    9. Manchikanti et al. 2017. Evolution of US Health Care Reform. Pain Physician: 20:107-110

    10. Mehrotra A and Prochazka A. (2015). Improving Value in Health Care  - Against the Annual Physical. NEJM 373;16;1485-1487.

    11. National Health Committee (2004). Prioritising Health Services. A Background Paper for the National Health Committee. 4-29.

    12. Nordic Federation of General Practice (2016). Position Paper: Overdiagnosis and related medical excess

    13. Oberlander J, Marmot T, Jacobs L (2001). Rationing medical care: rhetoric and reality in the Oregon Health Plan. Can Med Assoc J 164(11):1583-1587.

    14. Olejaz M, Nielsen AJ, Rudkjøbing A, Birk HO, Krasnik A, Hernández-Cuervo C (2012). Denmark: Health System Review. Health Systems in Transition, 14(2). Read: Executive Summary: xvii-xxii

    15. Pedersen KM, Andersen JS and Søndergaard J (2012). General Practice and Primary Health Care in Denmark. J Am Board Fam Med, 25(Suppl_1):s34-s38.

    16. Rice T, Rosenau P, Unruh LY, Barnes AJ. Saltman RB, van Ginneken E (2013). United States of America: Health System Review. Health Systems in Transition, 15(3). Read: Executive Summary: xxi-xx

    17. Saltman RB & Figueras J (eds.). 1997. European Health Care Reform: Analysis of Current Strategies. Copenhagen: WHO Regional Office for Europe. Read pages 2-3 ("Defining reform")

    18. Vallgårda S (2008). Comparative studies. In: Vallgårda S, Koch L (eds.) (2008). Research methods in public health (1st ed). Copenhagen: Munksgaard: 201-218.

    19. Vallgårda S (2008). Social inequality in health: Dichotomy or gradient? A comparative study of problematizations in national public health programs. Health Policy 85:71-82. Please focus on paragraphs 1., 3., 4., 5., 7., 8. Rest of paper is optional.

    20. Vuorenkoski L, Mladovsky P, Mossialos E (2008). Finland: Health System Review. Health Systems in Transition, 10(4). Read: Executive Summary: xv-xix.

    21. Willems DL (2001). Balancing rationalities: Gatekeeping in health care. Med. Ethics, 27(1):25-29

     

     DIS - Study Abroad in Scandinavia - www.DISabroad.org

    Course Summary:

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