CAHME-I-Final-Report-International

4 Assess the extent of international healthcare management education activities of CAHME accredited programs and their faculties and describe involvement in international health administ

International Healthcare Management Education

Daniel J West, Jr., Ph.D., FACHE, FACMPE

Professor and Chairman Department of Health Administration & Human Resources

Panuska College of Professional Studies

Jill Steinkogler, MHSA

Senior Consultant Atlas Research, LLC

CAHME

This study was made possible through a grant from the ARAMARK Charitable Fund at the Vanguard Charitable Endowment Program Additional contributions were received from the University of Scranton, Department of Health Administration and Human Resources and Atlas Research, LLC

ACKNOWLEDGEMENTS 2 

INTRODUCTION 5 

OVERVIEW OF THE STUDY 6 

Domestic Methodology 8 

International Methodology 9 

The University Survey   9 

The Survey of Informed Leaders   10 

SURVEY FINDINGS AND OBSERVATIONS 11 

Domestic 11 

Overview   11 

Limitations   11 

CAHME Survey Results   12 

Observations   12 

International 13 

The 16 Country Programs: An Overview   13 

CONCLUSIONS 21 

Domestic 21 

SUGGESTIONS FOR FURTHER STUDY 24 

APPENDIX A: INTERNATIONAL DATABASE 26 

APPENDIX B: COUNTRY PROFILES AND PROGRAM TEMPLATES 27 

Australia 27 

Australia: Programs 31 

Brazil 41 

Brazil: Programs 46 

Chile 50 

Chile: Programs 54 

China 58 

China: Programs 63 

France 67 

France: Programs 71 

India 77 

India: Programs 82 

Mexico 99 

Mexico: Programs 103 

Philippines 111 

Philippines: Programs 115 

Saudi Arabia 117 

Saudi Arabia: Programs 117 

Singapore 122 

Singapore: Programs 126 

South Africa 127 

South Africa: Programs 131 

Spain 135 

Spain: Programs 138 

Sweden 139 

Sweden: Programs 142 

Turkey 144 

Turkey: Programs 148 

United Kingdom 150 

United Kingdom: Programs 155 

APPENDIX C: CAHME SURVEY RESULTS 168 

APPENDIX D: PRESENTATIONS AND CONFERENCES 198 

APPENDIX E: SAMPLE LETTER TO INFLUENTIAL LEADERS 199 

COUNTRY HEALTH SYSTEM ABSTRACT SOURCES 200 

INTRODUCTION

We live in a global village where the geopolitical landscape changes rapidly In fact, change is the only constant in the globalization equation This global transformation involves all sectors of the global economy and provides unique challenges and opportunities to rethink business

strategy The academic landscape is also changing Ben Wildavsky in this book “The Great Brain Race” (2010) offers insight into the new university globalization movement suggesting that higher education is now a form of international trade

According to Wildavsky:

Three of the most important higher education trends of the last half century – mass access, growing reliance on the merit principle, and significantly greater use of technology- will all be accelerated

by globalization And there is no reason to believe that gains for one academic player will mean losses for all the other Indeed, academic free trade may

be more important than any other kind (p 8)

A recent article in “The Chronicle of Higher Education” titled “University Mergers Sweep Across Europe” (January 7, 2011, p 1) suggests that mergers and acquisitions among universities will continue as efforts are made to improve research quality, economic competitiveness and

international reputation Academic free trade will have national and international implications that reshape higher education worldwide Joint programs of study, cross-disciplinary research and other venues for collaboration will emerge in response to global economic pressures

The idea of a borderless world in higher education, as well as a movement towards consolidation,

is augmented by the infusion of investments in investor owned universities in China, India, Mexico and Saudi Arabia, among other countries The international mobility of students and faculty along with for-profit growth will only serve to enhance and reshape the global academic

landscape Opportunities for new growth and innovation will expand and attract new

investments

The accreditation of healthcare delivery programs in Europe during the 1990s responded to national efforts to improve quality of healthcare This investment has been reviewed by WHO and reported by others (Shaw, C.D., Kutryba, B., Braithwaite, J., Bedlicki, M & Warunek, A., 2010) It is clear that the trend for each country to develop its own standards is not new

Career ladders for professionals vary by regions, and the recognition of credentialing processes

is not uniform and consistent across professional organizations Given the diversity of countries and the variation in professional identity for health care management professionals, accreditation has a variety of purposes and orientations among regions of the global community

Medical tourism provides another variable in the globalization of healthcare This trade

movement has a significant economic access and quality of care impact The idea that clinical outcomes can be linked to quality management and hospital performance is not new, but is not accepted globally The institutional framework and competencies of each profession suggests that although a common body of knowledge exists, there can be different expected levels of competencies, and that competencies can be country specific especially in the areas of law, ethics, financial management and public policy Nationalistic concerns for quality may out weigh

international criterion

Given the aforementioned mega-trends, in addition to the Development Goals (DGs) for

emerging economies an opportunity exists to develop an international platform to examine health management education competencies, certification, and accreditation There is room for

discussion, but the context and origin of standards raises issues in many countries The high level

of diversity among countries, varying levels of professional identity, a tendency towards national standards, and an orientation that currently values public health, all suggest that new models are needed within an international framework that embraces diversity rather than homogenous

thinking

The International Hospital Federation (IHF) may provide a framework to examine the relationship

of hospitals, competency development, models of certification or credentials for healthcare

managers, and the emergence of health management education as a viable professional

preparation The World Health Organization has been trying to improve competencies for managers especially in low and middle income countries, but their professional orientation is towards public health administration Business schools have an increasing presence, but do not have significant recognition as a health care management training venue, especially at the CEO, CMO, COO, and CNO levels This being said, a niche exists for health management education in countries where professional organizations and identity are established

OVERVIEW OF THE STUDY

This survey research is an initiative of the Commission on Accreditation of Healthcare Management Education (CAHME), implemented by the University of Scranton and Atlas Research, LLC It is supported primarily by the ARAMARK Charitable Fund with contributions from the University of Scranton and Atlas Research, LLC The project team included:

Daniel J West, Jr., Ph.D., FACHE Principal Investigator

Gary L Filerman, Ph.D., MHA Senior Vice President

Atlas Research, LLC

Bernardo Ramirez, MD, MBA Assistant Professor & Consultant

Jill Steinkogler, MHSA Senior Consultant

Atlas Research, LLC The study was limited in scope due to the constraints of the grant However, the effort is

considered to be Phase I of a multi-phase study It is assumed that Information gained in the first phase will be used to structure future studies in Phase II and Phase III

The grant award had a domestic initiative/methodology and an international

initiative/methodology Specifically the study was structured to:

1) Examine the supply and demand for professionally trained healthcare administrators in

sixteen countries A country profile template was created Within each country program profiles were created that provide information on universities, degrees awarded, and other information

2) Provide a summary of the health systems of the 16 countries

3) Use an expert panel to provide opinions, advice, and access to information

4) Assess the extent of international healthcare management education activities of CAHME

accredited programs and their faculties and describe involvement in international health administration education

5) Prepare recommendations on future areas of study with relevant research questions for

Phase II and Phase III

6) Suggest ideas for conferences, presentations, and other venues to disseminate the results

of the project

As part of the study five monthly progress reports were prepared and submitted to CAHME Continuous input and contact was maintained with Mr John Lloyd providing clarification and utilizing appropriate feedback The expert panel was used extensively throughout the study by

Dr Gary Filerman and his staff at Atlas Research, LLC The University of Scranton provided marketing and publicity associated with the study Suggestions have continuously been sought from a variety of sources on presenting results of the study in journals and at professional

meetings/conferences, both in the USA and to international audiences

The project study team met for the initial planning session on June 21-22, 2010 at the University

of Scranton, Scranton, Pennsylvania A study strategy was discussed and agreed upon, along with descriptions of responsibilities, allocation of resources and time frames Desirable outcomes were explored as well as study limitations Throughout the study contacts were maintained via telephone conferences on a monthly basis as well as weekly telephone calls and e-mail Reports were shared as they became available with other team members As stated previously, Dr West

prepared and submitted monthly progress reports to Mr John Lloyd at CAHME, who in turn

shared information on the study with the CAHME Board of Directors and international advisory committee

Domestic Methodology

The study required a survey of CAHME accredited programs and their faculties and a description

of their involvement in international health administration education In the design of the survey instrument, specific information points of interest to CAHME were considered Information and questions used on an earlier AUPHA survey prepared by Drs Dominquez, West and Ramirez was reviewed The survey responses on the Global Healthcare Management Faculty Survey were very small so the results could not be used with the CAHME study Authorization was received by authors of the Global Healthcare Management Faculty Survey to use some questions on the new

“CAHME International Health Management Education Survey.” A literature review was conducted

to see if other international healthcare management questionnaires had been previously

constructed and administered Finally, faculty and colleagues with international health

management education experience were asked to review the constructed survey and offer

suggestions for improvement The project team reviewed the survey construction, format and question design prior to IRB review The CAHME International Survey was administered to a pilot group of faculty at other AUPHA programs to insure clarity, determine length of time to complete the study, and to receive suggestions in the ordering of questions in the various sections of the survey This field test was useful to the final design and wording of questions

The project team submitted an IRB/DRB Application Form B on October 12, 2010 at the University

of Scranton IRB approval was received on November 3, 2010

The CAHME website and office was contacted to secure a listing of all CAHME accredited

programs in the United States and Canada A total of 72 programs were listed Two accredited programs had two separate CAHME accreditations but the University was only surveyed once A total of 70 surveys were administered

The survey was titled “CAHME International Health Management Education Survey” and was composed of 39 items The questions were grouped into five sections: demographic information, international involvement, international courses and curriculum, alumni, and ideas/opinions on

global healthcare management education A copy of the survey is illustrated in Appendix C All

program directors were asked to complete the online survey at:

http://www.surveymonkey.com/s/HPKJF53The initial survey request was sent to all CAHME accredited programs on November 12, 2010

Mr John S Lloyd, President and CEO, CAHME sent a letter of support to all CAHME program directors on December 3, 2010 encouraging participation A second notice and request was sent

on December 9, 2010 to program directors who had not responded to the initial e-mail A 3rdnotice and request was sent on December 17, 2010 to program directors who had not

responded A 4th and final request was sent to 12 program directors on December 29, 2010 In

addition to e-mail requests, telephone calls were made to program directors on two separate occasions to increase participation in the CAHME survey Only one CAHME accredited program expressed an unwillingness to participate in the survey The survey was closed on January 5,

2011 As of that date out of 72 programs surveyed, 66 responded and 6 did not respond The overall CAHME participation rate was 91.67%

International Methodology

The study team had the benefit of counsel from an advisory committee that reviewed the design and suggested sources of information about programs The members of the committee were:

• Gilles Dussault, Ph.D Professor, National Institute of Hygiene and Medicine, Portugal

• Alex Preker, MD, Ph.D Lead Health Economist, The World Bank

• Bernardo Ramirez, MD, MBA, Assistant Professor and Director, Global Health Initiatives, University of Central Florida

• Anne Rooney, RN, MS, MPH, Vice President, Consulting and Education Services, Joint

Commission International

• Jorge Talavera, Ph.D Rector, Universidad Esan and Executive Director, CLADEA, Peru

The University Survey

The intent of the international study was to identify university and other providers of

programs that lead to a credential that is recognized by the health services delivery

system/community as attesting to the successful completion of a course of study that is

appropriate preparation for management practice

We identified, researched, and contacted many potential sources of information about

specific health care management education programs Unlike the case of schools of medicine, public health and nursing, there is no international directory, registry or other guide to

programs in health services administration It was therefore necessary to contact many sources

of information on components of the field Each of them was sent an e-mail inquiry that

included the project general information sheet As the data base expanded, a summary paper for each country was developed that included sections listing key professional

organizations, governmental agencies, employers and education providers and their contact information The summary paper was forwarded to many of the contacts with the request they review it, adding missing details and correcting any information

The identification effort included inquires to:

• The American College of Healthcare Executives, for international members

• Joint Commission International, for the members of regional advisory committees

• The World Health Organization Division of Human Resources and regional offices for Europe, India and Southeast Asia

• The Pan American Health Organization, Divisions of Health Services and Human Resources

• The World Bank, various regional health sector leaders

• The European Healthcare Management Association

• The King’s Fund

• The International Hospital Federation

• The Global Business School Network

• Association of University Programs in Health Administration for subscribers to the JHAE

• World Association of Schools of Public Health

• The Association of Schools of Public Health in the European Region

• The World Federation of Public Health Associations

• The African Association of Business Schools

• AACSB International, for accredited business schools

• European Foundation for Management Development: European Quality Improvement System(EQUIS),European Programme Accreditation System (EPAS) for accredited business schools

• Consejo Latinamericano de Escuelas de Administracion

The education provider section of the summary paper was developed based upon the

information provided by the above listed organizations, program files, personal contacts and journal articles The result is that our inventory of the sixteen countries is the most

comprehensive data base for them that has been developed since the publication of the AUPHA directories in the 1970’s and 1980’s

A web search was conducted on each education provider A profile of each was then

developed The profile and the project description were then sent to each program for which

we found an email contact with a request that it be checked for accuracy and completeness

and be returned Appendix A, a separate document is an Excel spreadsheet providing depth information on each program Appendix B provides an in-depth list of the country

in-profiles and program templates filled out for each country Over 200 contact emails were sent with a response rate of about 10% Useful information about programs in China arrived too late for the profiles to be sent to the programs for confirmation before the end of the study

*Note: due to current UK legislation, contact information for program staff (professors and department leadership) may no longer be provided online through university websites

The Survey of Informed Leaders

The survey consisted of a letter with three questions and an open-ended request for opinions

and observations (Appendix E) The primary target was 22 members of the JCI regional

advisory committees who are located in the 16 study countries We assumed that they are important and informed observers who would be interested in the study The letters were sent

by email, using the JCI address list, the first week of December and we had one response by the end of the month

Similar requests were directed to the leaders of several health administration practitioner organizations, national hospital associations and CEOs of hospital systems, with very poor response Responses received after the close of the study will be forwarded to CAHME.

SURVEY FINDINGS AND OBSERVATIONS

Domestic

Overview

The CAHME International Health Management Education Survey consisted of 39 questions placed in five sections: demographic information, international involvement, international courses and curriculum, alumni, and ideas/opinions on global healthcare SurveyMonkey was used to administer the questionnaire, organize responses and calculate results This section of the report presents tabulated results for each question along with summarized responses for those questions that asked for further details, descriptions or explanations For each question the responses are organized by “response percent,” “response count,” the number who

“answered question,” and the number who “skipped the question” A copy of the survey is

illustrated in Appendix C The survey was sent to 72 programs in the US and Canada and

66 Program Directors (PDs) responded giving a response rate of 91.67%

Limitations

This study had several limitations that must be recognized and considered when drawing conclusions from the responses by 66 CAHME accredited programs These limitations should also be considered when designing and implementing follow-up studies as contemplated by CAHME for Phase II and Phase III

Based on the responses, it is not possible to know why some Program Directors (PDs) elected not to respond to all questions Several PDs skipped questions that asked for additional clarification and information Some of the PD responses were very general lacking in

specificity For other questions, some PDs responded “yes” but did not include the additional response information to explain or clarify responses given Very low responses were

obtained on questions dealing with international involvement (questions # 22, #23, #24) that focus on faculty teaching assignments and courses The same holds true for the section of the survey focusing on international courses and curriculum (questions #25, #26, #27 and #28) Another limitation is that PDs may not be knowledgeable about what faculty are doing

internationally It may have been more appropriate for someone other than the PD to

complete the survey There was a short period of time to respond to the questionnaire

(November 12, 2010 to January 5, 2011) during which time most universities had holidays, final exams and closings for the holidays The length of time to complete the entire study negated the ability to follow-up with PDs to request clarification and/or obtain additional information on specific questions Finally, CAHME contact information was not always

accurate or complete in terms of who was the PD, e-mail addresses and telephone numbers This made follow-up difficult in terms of finding the correct PD to complete the survey

CAHME Survey Results

The following observations summarize findings presented from the surveys per Appendix C

Tin addition to graphic presentation where appropriate, responses to open-ended questions are also included

• Programs do provide some study abroad (30%), student exchanges (18%), faculty

exchanges (33%), online graduate courses (39%) and service learning abroad (27%)

• 32% (N=20) of faculty have grants with an international focus; international projects 37% (N=23); involvement in international research studies 51% (N=31)

• Only 9 programs (14%) have a graduate program or school/college campus located in another country and only 5 of the 9 programs consider this an abroad campus Only 1 program teaches a healthcare management education course at this location

• 19 programs (31%) have international healthcare management partnerships, 43

programs do not (69%) Most of these programs are located in Western Europe, Central Europe and Asia and are university based partnerships

• 49 programs (82%) encourage and support faculty to present at international

meetings/conferences; 78% (N=48) to publish in international journals; 63% (N=38) to lecture at foreign universities; 64% (N=38) to serve on international committees; and 64% (N=37) to take an international sabbatical

• Most faculty take sabbatical leaves in Western Europe followed by Asian countries 43%

of programs (N=23) have faculty members who have taken an international sabbatical leave

• 15 programs (26%) reported having faculty who serve on editorial boards of

international journals but only 8% (N=5) provide financial support for an international journal

• 18% of programs have faculty who hold visiting faculty appointments (N=11); 13% of programs jointly sponsor international conferences (N=8); 13% of programs reported teaching courses at foreign universities (N=8); and 16% of programs (N=10) market themselves to specific countries or have a specific international strategy

• Of the program faculties who teach courses in other countries, 89% are full-time faculty followed by 57% who use adjunct faculty to teach courses When faculty participate in international teaching assignments, 23% (N=6) receive release time, 19% (N=5)

reassigned time, 50% (N=15) receive travel funds , and 36% (N=10) receive additional compensation

• Of the programs who teach courses internationally, 62% (N=16) teach face-to-face with

no online courses, and 36% (N=10) use a blended model offering abroad selections of courses Of the courses taught, 20% (N=5) address global healthcare management competencies

• 48 programs (83%) do not offer a track or concentration in global healthcare

management and 10 programs offer some type of international courses Only 4

programs (7%) offer a certificate in international healthcare management education

• Most foreign graduates of CAHME programs who work in international settings are in Asian countries (namely China, Indonesia, Taiwan, Philippines, Thailand, Japan, Singapore, and South Korea) followed by Middle East countries 56 different countries were

identified by CAHME programs where foreign graduates work

• 23 programs (40%) indicated that foreign graduates are active in their alumni association

re 60% (N=34) are not active 23 programs (40%) reported that foreign graduates help recruit new graduate students, and 33% of programs “didn’t know.” When asked about the number of alumni (both domestic and foreign) who are working outside the US

or Canada, 23 programs reported between 1 – 25 people and 12 programs reported

“unknown”

• 44 programs (76%) do not feel international healthcare management education should be included in CAHME accreditation standards 43 programs (74%) do not feel CAHME should have specific health management education course competencies However, when programs were asked if CAHME should offer accreditation to programs outside of the US and Canada, 63% (N=35) of the PDs indicated “yes” but, provided no explanation

• 44 programs (75%) had no suggestions for future research Other programs felt the questionnaire could be modified: more details on partnerships, how will CAHME help programs outside of the US, identify courses that are best taught cross-culturally, defining global health management, what would CAHME actually do internationally, and

documenting student outcomes

International

The 16 Country Programs: An Overview

Table 1 provides key health data for each of the 16 countries studied Appendix B provides

a detailed chart for each country with specific information regarding the economy, political status and brief description of the health care environment of the country For those countries that do not have data on the specific number of hospitals, footnotes (a-e) provide data on the proportion of beds available through either public or private hospital facilities

Table 1 Country Overview

Country Population

GDP Per Capita ($)

Health Care Spending

as a %

of GDP

Public Hospitals Number of Beds Hospitals Private Number of Beds

Mexico 112,468,855 13,500 5.9 1,107 a - 3,082 33,931 Philippines 99,900,177 3,300 3.9 700 - 1180 85,000

a Includes social security hospitals

b 47 total hospitals provide 66% of all hospital beds

c Public hospitals provide 62% of all hospital beds

d 18% of private beds not for profit, 20% for profit

e 21,000 total beds provided through public and private hospitals

Table 2 summarizes our findings of Master’ degree programs in the study countries It

includes those programs that are designated by the degree granting institution to be at the

Master’s level Master’s degrees vary in length within and among countries so it is necessary

to track each one to determine to what extent it approximates the North American model

Table 2 summarizes Master’s data from the total report spread sheet It does not include the

programs that are designated as diplomas, which are included on the spread sheet, along

with certificates, specializations, Bachelor’s degrees and doctoral degrees The interpretation

of diplomas presents a complicated challenge In some countries some diplomas in health

administration (or related title) are considered to be equivalent to a Master’s degree, while in

some of the same countries diplomas are also awarded in recognition of two month courses In

some countries diplomas represent a postgraduate clinical specialization There is an effort to

standardize such titles in Europe, but it has not had any influence on other parts of the world

Appendix A provides a comprehensive spreadsheet that displays information specific to

programs in each of the countries This includes the name of the institution, and to the extent

available, degrees offered, duration of each program, language in which courses are taught,

the number of graduates per year, year each program started, and key contact information

including name, title, address, phone number and email information

Table 2 Master’s Programs

Country Universities: Active in the Field Offer Master’s Degree Master’s Degrees Offer Multiple

The scope of the career addressed by the study University-based programs (and in a few

cases professional societies that confer the equivalent of a degree) that attract individuals

who aspire to enter the field or incumbents seeking credentials and prepare them for

management positions in health services delivery entities, with decision-making authority,

whether government or non-governmental (e.g ministries, military health systems, national health institutes,) provider or payer organizations (e.g national insurance programs, social security systems, quasi-governmental companies, hospitals or hospital integrated health

systems, physician’s groups, health centers, etc.) or community stakeholder or consumer

groups.1,2

Based upon our observations of the 16 study countries, we conclude that it is helpful to

visualize the status of the education system for health administration and the place of health administration careerists in the service delivery system in terms of the degree of alignment (congruence) between the two The situation analyses of the countries can be arrayed from those that are highly aligned to the less aligned In the highly aligned situation most, if not all,

of the senior positions in the public and private health services delivery systems are either occupied by individuals with recognized credentials in the field, and/or the credential is a distinct advantage for appointment or promotion

In the highly aligned situation the health systems administration education system is closely articulated with the recognized competency needs of the system and is producing a sufficient number of graduates to meet a substantial portion of the demand There is a high degree of professional identity and credential holders are likely to remain in the field The only country that comes close to this ideal model is Israel where the law requires that senior managers in the provider systems have recognized health administration credentials The requirement provides the demand that drives the educational system to respond

At the other end of the spectrum the degree of alignment is low, often reflecting low

recognition of management degrees/credentials in other sectors Overall recognition of the value of the credential is limited, usually to a few large government hospitals in capital cities and large private providers The credential is rarely cited in position qualifications, there is little professional identity among administrators, there is not a career path associated with the credential and individuals with the credential often move to other kinds of higher paying organizations There are few programs and usually there are a small number of students,

1 We use the term “health system” as it is used in the U.S./Canadian context, to include the many related or not related governmental, not-for-profit and for-profit organizations with the primary mission of providing health services The term includes supporting functions such as finance and regulation that are considered to be

extensions of the health administration career space It does not include the supply, device or pharmaceutical industries

2 We use the term “educational system” as it is used to describe Master’s degree providers in the context of the specific country The educational system that addresses the health administration career varies among the study countries For example, in India professional societies may control a degree that is recognized as professional There are many variations of program content and length (variously defined in terms of hours, days or months, full-time or part-time), often within one country, that lead to a diploma We have not assessed them for

equivalency to the Master’s degree and have generally not included diplomas within the scope of the educational system for purposes of this study

reflecting the limited market This describes several of the study countries The Philippines is representative, where two programs produce relatively few graduates who may go to middle management jobs in the large private hospitals that are concentrated in the three major cities However, many find employment in health related businesses such as pharmaceuticals,

supplies, information management or insurance or do not enter the field The exception is the national school of public health program that provides credentials to present or potential employees of the public health system

In addition to Israel, higher degrees of alignment characterize Australia, the UK and France

In these countries management credentials enjoy wide recognition in other sectors, such as business, education and government, so the health system reflects the general management education culture In Australia there is a high degree of recognition of the credential by employing authorities, both public and private The professional environment in Australia is more similar to that of the US and Canada then in any other of the study countries There is a similar infrastructure of professional organizations (including the Australasian College of Health Services Management), public and professional recognitions of educational

attainments, professional journals and meetings Accordingly, the degree of professional identity is high The educational system is relatively robust, with many programs, some of them in leading universities There is an active association of programs and program

accreditation by the Australasian College This pattern was influenced by the investments of the W.K Kellogg Foundation, paralleling their efforts in the US and Canada

In France and the UK the status of the health administration “profession” is strongly shaped by the civil service systems Also, both countries have small but robust for-profit systems that are dominated by physicians without management credentials, but both are experiencing inroads

by MBAs This reflects recent developments in the general business sector

The French health system is based upon universal health insurance that supports institutions owned by the public, not-for-profit and for-profit sectors General management is a widely respected tradition that influences health services France has a strong tradition of civil service generalist management training led by a few elite universities but including many others The graduates enjoy a distinct status and often move among public and private organizations in different fields during their careers As a result, many of the occupants of top positions in major public health facilities do not identify themselves as professionals in health care

administration although some do Private sector hospitals are generally headed by physicians who are supported by administrators They have recently been hiring MBAs for senior

management positions The National School of Public program has fed into the civil service system for over 60 years, but it’s identity with the curative field, as opposed to pubic health administration, has been uneven, depending upon the leadership of the moment

The profession has been robust in the UK for over forty years, but it is facing an uncertain future because the government has very recently announced a major down sizing of the NHS management workforce and the closing of several management structures In the past the National Health Service has encouraged universities to provide credentials, even to point of

enlisting and supporting them to participate in NHS national training schemes but this high degree of alignment has ended Position descriptions generally specify health administration credentials, there is a high degree of career identification and a professional infrastructure that reinforces the identity (including the British Society of Medical Secretaries and

Administrators and the Institute of Healthcare Management), with some union-like

characteristics Criteria for IHM membership mention but do not require a credential in the field The proposed changes will considerably expand the relatively small private sector The health administration education system is very large, with many programs in a variety of settings offering a variety of credentials, extensive health services and policy research, and continuing education It has largely focused upon the NHS but can be expected to respond to the increasing private market The UK has recently experienced rapid expansion of MBA programs that will likely respond to new opportunities in the health sector

The relatively high health status that Spain has achieved in very recent years is attributed in part to an effective health care system in which management competence and quality

improvement are well regarded Most hospitals are non-profit or for-profit and have been early adapters of advanced information and other management systems It appears that most hospitals, health centers and related entities are headed by physicians, many of whom are part-time They are supported by administrators, for whom there is an extensive pattern

of short courses under public and private sponsorship The products of the two university programs occupy mid and upper level supporting positions in the large university hospitals, health insurance and in the private for-profit sector The fact that there are only two

programs targeted to the field in Spain’s large health education system suggests that the credential is not in demand

Mexico presents interesting contrasts between relatively high alignment between education and urban health systems, where credentials enjoy some recognition, and low alignment with most of the rest of the country National government and quasi-governmental systems, the petroleum and railroad company systems and growing for-profit chains are concentrated in the national and state capitals and secondary cities, with many very small facilities in rural areas The world-class government teaching and research institutions, not-for-profit and proprietary hospitals of the capital employ many physicians and others with credentials from the nine programs Nationally, non-physician CEOs are rare There is a general pattern of hospitals having second level administrators, many of whom have Bachelor’s in business

administration Ministry and social security headquarters employ Master’s graduates in supporting roles to politically appointed physician CEOs There have been full- and part-time programs in Mexico City since the late ‘50’s and recently some dispersion to other cities Health services research is well established at the National School of Public Health and there are several journals for leaders in administration The early developments were influenced by the Kellogg Foundation The quasi-governmental Mexican Social Security Institute which owns over 200 hospitals has contracted with private universities for custom MBA programs for the CEOs and administrators of larger hospitals Mexico is experiencing MBA growth with some interest in health related businesses

Chile is an interesting case of professional development, with a moderate degree of

alignment between education and the market Recognition of professional management education across sectors is recognized to be the highest in Latin America Relative to the size

of the health delivery system, the health administration educational system is quite strong There is a long tradition of graduates of the University of Chile occupying important

management positions in the pubic systems, although the CEO positions are often occupied by physicians without credentials in the field There are now two universities offering four

degrees, which reflects how well the credential is established This is another case where the Kellogg Foundation played a key role in the early development of the field Graduates of the present and past programs often occupy COO and other senior positions in larger public institutions There are some professional activities that reinforce the identity of the field, including a professional organization and a history of publication Chile too has seen a recent growth of MBA programs focused on the business sector and there has been some movement

of graduates into the health field, particularly into the private hospitals in three or four cities Saudi Arabia’s large and advanced health system employs many individuals with credentials

in the field There are indications that a significant number of credentialed people leave the field for better paying opportunities in other sectors The two programs are strongly

influenced by the US model and have modest enrollment Health services are provided by the separate systems of several ministries, the National Guard, industries such as ARAMCO (the national oil company), universities and others The larger of these function as internal training markets At least two large systems, the National Guard and ARAMCO, have supported Master’s level courses for their employees Some of the courses have been held in the US and the UK while foreign faculty have been brought in for others This has led to a large and growing private sector, which appears to be drawing managers from the general business market

Sweden and Singapore present situations that are distinct from the other study countries There are no formal education requirements for most positions in Sweden CEOs come from diverse backgrounds; many are MBAs, H.R specialists and some clinicians Many are political appointees Sweden has a strong tradition of education for general governmental social services management The Karolinska Instituet, which has the only part-time health

administration Master’s, will add a full-time two-year program this year Health

administration diplomas, mainly for clinicians, have been closed in response to the Bologna process Some key positions have been occupied by graduates of the multi-national Nordic School of Public Health Master’s program (in Norway), which enjoys high regard but does not prepare significant numbers of people for the field

Singapore is a single city dominated by two large “public” systems (government owned, but operated as if private not-for-profit) and a large private sector It appears that credentials

in the field are widely recognized and valued There is an active chapter of the Australasian College of Health Service Management The education sector has responded with four

programs including one that is affiliated with Flinders University of Australia Apparently the largest and most influential contributor of recognized credentials has been the Minnesota

Independent Study Program which enjoyed a substantial enrollment over several years, but was recently closed

Our sample included four countries, Brazil, India, South Africa and Turkey that are developing rapidly but unevenly In the major metropolitan areas they have strong health administration education systems that are aligned with the delivery systems of the metro areas They have vast small town and rural areas where the health and education centers can be characterized

as being fifty or seventy five years behind the urban centers, that is, with very low alignment

in health services administration and education All are in stages of implementing universal health insurance that may be expected to drive rural service expansion and expansion of the profession, but that is long-term speculation

Brazil is the most advanced and is demonstrating that insurance coverage stimulates service provision that creates opportunities for health administrators It has a fifty year old tradition

of hospital administration education based in the schools of public health, Catholic hospital systems and large government university hospitals There are schools of public health, public administration and business administration that are considered to be world class and have been engaged in health administration and policy with support from Kellogg, Rockefeller and local foundations The numbers of graduates has been small relative to even the urban

market but they are influential leaders in administration and policy There are professional associations of administrators and a tradition of periodical and text book publishing for the field Rural health service and education development is a national priority that is driving the expansion of universities in general, business, and public health education There is an effort

to expand public health education to as many as 40 new regional centers backed up by distance learning programs It is not clear if and when they may address health services administration but lack of qualified faculty will be a challenge Credit mechanisms are being expanded to stimulate private sector federal health insurance supported hospital expansion in mid-range cities which will contribute to the demand for credentials

It may appear that the 20 universities in India that are involved in education and/or teaching for the field are sufficient to constitute the beginnings of a “critical mass” to underpin the profession However, most appear to be isolated from each other and to have very limited impact upon management practice The experience in other countries suggests that a stimulus (a Kellogg-like strategy) could quickly organize the field, stimulate growth and improvement

in programs and lead to the dissemination of managerial competencies into the health system That would be in concert with the rapid expansion of management education and the growth

of sophisticated business entities India has a strong tradition of professionalism in the health professions and rudiments of a health administration infrastructure, including several

professional organizations at the state level, are in place The recent rapid growth of large and successful for-profit hospital chains has focused attention on the role of qualified

executives and can be expected to strongly influence their status in the other sectors, but government services continue to carry the burden of the over-sized and overly bureaucratic civil service Catholic health care, the largest non-governmental system (with something like

20% of the beds), is considering founding a program, which would be very influential in setting the pattern

Turkey and South Africa are very early in the development of the field but the fact that two

or three of the most influential universities are involved bodes well for the future The

programs have small but well-qualified faculties that are networked internationally Both countries have strong for-profit sectors with highly visible business leaders, which can be expected to influence the management pattern in the public sector

China presents a unique situation There are thousands of entities in the health system owned

by many governmental units and a relatively few hospitals in the growing private sector The programs, which are primarily health economics and health services research centers, are very small resources for healthcare management education relative to the potential demand There does not appear to be much communication among them There are organizations of physician CEOs in some metropolitan areas but we found no central source of information about them, their members or activities It is possible that the recent health reform law that prescribes major changes in hospital management practice that will stimulate expansion of the education sector Much will depend on the mandates of the government to be elected in March 2012

CONCLUSIONS

Domestic

The International Health Management Education Survey was sent to 72 CAHME accredited

programs with 66 PDs responding This significant response rate of over 90% for accredited programs provides a foundation to understand the types of international program activities, faculty activities, involvement of alumni, international courses, curriculum and ideas of programs on globalization This study represents the first attempt to compile international information on CAHME programs that will help define future strategy and direction for schools, colleges, and programs

Approximately 30% of programs have international involvement of some type University-based partnership models have been identified as a venue for different types of educational endeavors from courses, workshops/seminars, short courses, certification courses, and lectures Faculty

activities include international grants, international research, projects, publishing in international journals, and encouraging study abroad There is a high probability these types of activities will increase A limited number of faculty hold visiting faculty appointments at universities outside of the USA and Canada

CAHME programs are involved in many countries but the focus seems to be on Asian, Middle Eastern and Western European countries Joint degree programs of study are rare and very few PDs report having campuses located in other countries There are a variety of different courses being taught in international settings, (mainly or mostly business administration and public health) but few courses in health management education or concentrations in health management

education A limited number of programs teach courses at foreign universities and only 10 PDs reported that they marketed programs to specific countries or had a specific international

marketing strategy

The number of programs having specific courses on global healthcare management is very small Only four PDs reported offering a certificate in international healthcare management However, several programs have foreign graduates who are alumni and help recruit new students The number of alumni (both domestic and foreign) working outside the USA or Canada varies across programs

Approximately 30% of PDs reported that their graduate programs provide study abroad,

student exchanges, faculty exchanges, online graduate courses, and service learning opportunities abroad Only one program reported having a university or college global center through which healthcare management education is delivered A limited number of programs have faculty who take sabbatical leaves abroad and faculty who serve on editorial boards of international

journals Very few PDs reported subsidizing international journals financially, but provided in kind resources to these journals

Another interesting finding relates to faculty participating in the AUPHA Global Healthcare

Management Education Faculty Network (GHMEFN) Of the 60 programs responding, only 28% (N=17) reported yes to participation in GHMEFN, 45% (N=27) reported no involvement, and 27% (N=16) didn’t know if they participated An opportunity exists to begin supporting

international healthcare management education It is relevant to raise the question on how many corporate sponsors have an international presence or agenda that would also support

professional identity around global healthcare management education

The final section of the survey asked four specific questions to obtain ideas and opinions on

global healthcare management education: 76% (N = 44) of PDs reported they did not think international healthcare management educations (IHME) should be included in CAHME

accreditation standards; 74% (N = 43) of PDs did not think CAHME should have specific IHME competencies; 63% (N = 35) of CAHME PDs felt CAHME should offer accreditation to programs outside the USA and Canada; and 75% (N = 44) did not have suggestions for IHME research in the future

Opportunities will exist for CAHME programs to engage and embrace the global higher

education trade movement About 30% of programs have or currently are involved

internationally An opportunity exists for CAHME and AUPHA to advocate for increased

globalization of healthcare management training

International

The survey, limited as it was to 16 countries, presents a positive assessment of the present status

of formal education for the administration of health services and an encouraging perspective of the future The objective is the improvement of the health of all peoples through the improved management of expensive and scarce health resources, and specifically the improved

performance of systems Professional education for health services administration is a means, not

an end All of the countries have a university-based or related health services education

establishment but the national pictures vary greatly in professionalism, stature, resources and impact upon managerial practice In the study countries professional healthcare administration has in the past half-century become recognized, at least at some levels, as a desired if not

essential component of the health care workforce

The prospect is that the field’s recognition, stature and support will increase at an increasing pace across the study countries That is in response to the consensus among governments, planners, donors and all other global promoters of health services that the key to improving health status is not more money It is to improve the performance of health services and the key to that

improvement is competent management and strong leadership

At the same time it is increasing clear that management education/training/development is of limited value in environments of dysfunctional systems and institutions The point is particularly clear in the emerging economies, but to some extent to most of our sample when:

• National government health and education policy is unstable and inconsistent with changes of leadership

• There is a lack of coherent policy on decentralization of power from the national government

to local governments, public healthcare institutions or to the private sector

• Public hospital executives have little effective control of resources, systems or contracts

• There is little or no recognition of health administration credentials for appointment to senior positions

• Promotion of executives is based on political, family or clinical considerations rather than on managerial competence and career development

The point is that although some of these factors exist in the US and Canada, the differences in the environment for which we educate are wide and deep In most of the study countries it appears that professional education for health administration is not yet seen as a key to producing the necessary managerial competence and leadership There is growing recognition that clinical competence is not the same as managerial competence, but also that there are many clinicians with little or no managerial training who are successful managers and leaders That makes it difficult to change the culture, even in the context of improving system performance It does appear that in most of the study countries that professional administrators are gaining status (often as COOs) over poorly trained or performing physicians who do not see themselves as administrators

Several developments are converging that focus attention on the competency gap and to support the expansion of opportunities for credentialed individuals and for their education They include the rapid dissemination and adaptation of quality of care assessment and improvement In some

of the countries, aspects of information management for business and clinical functions are more advanced than in the US/Canada Another is the rapid expansion of the private sector, including hospitals, insurance and supporting services and the impact of highly visible international

accreditation It is important to note the increasing competitive influence of “medical tourism,” much of which is internal, as a stimulant for improved managerial performance

Developments in the education sector, including public health and business administration, as well

as health administration education are also converging to set the stage for expanded recognition

of credentials in the field A global expansion of public health schools and programs started about ten years ago and clearly will continue in both developed and emerging countries At the same time there is a recognition that traditional approaches to public health education have failed to deliver the management skills necessary to improve system performance Medical schools are expanding community medicine and health systems related courses and specialties Both are fueled by the world-wide growth of health economics and health services research The recent growth of the MBA is a far more potent development than we had anticipated,

reaching into virtually all of the countries Education for business is the most common feature of the expanding private for-profit universities in many emerging countries The MBA programs started with the US model but many are moving toward more indigenous approaches to

management and leadership as well as philosophies It has been promoted by the World Bank

as essential to foster entrepreneurship and as a fundamental strategy for business development

As the health care environment has become much more welcoming to private sector investment in all aspects of service delivery and financing, employment of MBAs has expanded, and as we have seen, some of the schools have followed It is likely that the executive MBA model (present

in Australia, United Kingdom, France and Sweden) will expand into the health sector in the coming decade The expanded use of English as the universal language of commerce is also a

contributing factor

Other important recent developments include the growth of customized graduate level programs

in several countries (e.g IMSS Mexico, Apollo India, Saudi National Guard); distance education (e.g Johns Hopkins, Virginia Commonwealth, University of Washington) and program teaming (e.g Flinders and Parkway, INSEAD and Singapore) and very importantly, the fact that the global market for graduate degrees has expanded to many countries (GMAT scores are now sent

in substantial numbers to France, UK, Spain, Australia, Singapore, India and Israel-all are in the top ten)

“It is not the decline of America but the rise of the rest”- Fareed Zakauia

SUGGESTIONS FOR FURTHER STUDY

This study provides the basis for complementary work that will produce a comprehensive picture

of the global status of education for health administration in universities To complete the picture

it is suggested that:

1 There be a second phase of national studies consisting of A) follow-up on the university

contacts that were developed in the first phase to obtain more reviews of the program

profiles and B) expand the study to other countries which may be significant participants in the field They are: Japan, South Korea, Malaysia, Taiwan, Thailand, The Czech Republic, The

2 The phase two study should put increased emphasis upon identifying professional

organizations of health care executives It is clear from this study that such organizations both reflect the status of the profession and may be significant players in promoting the field and activities such as program accreditation

3 This study has revealed that there is some, and perhaps growing, influence on health

administration education by accreditation programs in business, public health and perhaps medicine It would be informative to identify these accreditations; their domains (interest in health services administration), sponsorship, processes and memberships

4 Countries around the world are embracing standards to improve quality of care and access to care, although many of the standards appear to be predominantly nationalistic in orientation

It would be informative to survey international groups and organizations, external to the United States of America and Canada, on how useful and/or helpful external standards, metrics and competencies in health management education would be to improve management performance and improve quality outcomes

APPENDIX A: INTERNATIONAL DATABASE

The database can be found in the accompanying Excel spreadsheet This file provides specific information (to the extent available) for each program in each country including the institution name, program offered, qualification obtained, program affiliations, language in which the program is taught, duration of the program, number of graduates, year the program was

established and detailed contact information including website, address, phone number, key contact name and title, and email address when available The second and third tabs provide contact information for public and private organizations and employers located in each of the 16 countries

APPENDIX B: COUNTRY PROFILES AND PROGRAM TEMPLATES

65 years and over: 13.7% (male 1,350,248/female 1,607,146) (2010 est.)

Population 21,515,754 (July 2010 est.)

Muslim 1.7%, other 2.4%, unspecified 11.3%, none 18.7%

Languages English 78.5%, Chinese 2.5%, Italian 1.6%, Greek 1.3%, Arabic 1.2%, Vietnamese 1%, other 8.2%, unspecified 5.7%

Geographic

Size

Total: 7,741,220 sq km Land: 7,682,300 sq km Water: 58,920 sq km

ECONOMY

Economy

The Australian economy grew for 17 consecutive years before the global financial crisis The Australian financial system remained resilient throughout the financial crisis and Australian banks have rebounded Australia was one of the first advanced economies to raise interest rates - three times since October 2009 - and the government removed the wholesale funding guarantee for financial institutions in March 2010

During 2010, the government focused on building Australia's economic productivity by managing the economic relationship with China, passing emissions trading legislation, and dealing with other climate-related issues Australia is engaged in the Trans-Pacific Partnership talks and ongoing free trade agreement negotiations with China and Japan

GDP Per Capita $40,000 (2009 est.)

GOVERNMENT Type Federal Parliamentary Democracy and a Commonwealth Realm

Components

6 states and 2 territories; Australian Capital Territory, New South Wales, Northern Territory, Queensland, South Australia, Tasmania, Victoria, Western Australia

Chief of State: Queen of Australia Elizabeth II

Head of Government: Prime Minister Julia Eileen GILLARD (since 24 June 2010) Legislative Branch:

Bicameral Federal Parliament consists of the Senate and the House of Representatives

HEALTH CARE SPENDING

% of GDP 9.0% (est 2006)

Government

Australia’s health services are funded predominantly from taxation sources with federal, state, and territory governments, contributing close to 70% of all health spending

FACILITIES Hospitals

Public There are approximately 750 public hospitals

Private There are 290 private hospitals in Australia, representing 32% of all hospital beds in the country

Facilities:

Hospital Beds

Public Acute Public Psychiatric Private Hospitals Total

Available beds 50,915

(63.6%) 2,560 (3.2%) 26,589 (33.2%) 80,064 Available beds per

Australia provides universal health insurance through Medicare Medicare provides free or subsidized access to most medical and some optometry services and prescription pharmaceuticals It also provides free public hospital care, but patients may choose private care in public or private hospitals The Australian government, together with state governments in most cases, also funds a wide range of other health services including care of the aged, population health, mental health, limited dental care, rural and indigenous health and services for veterans The Commonwealth funds about 40% of the costs of services with the states making up the rest There is also a Pharmaceutical Benefits Scheme that subsidizes a wide range of prescription medications supplied by community pharmacies Payments are means tested

Medicare is funded mostly from general revenue and in part by a 1.5% income tax Some low-income individuals are exempt or pay a reduced tax Individuals and families with high incomes who do not have a certain level of private

insurance pay a 1% Medicare tax surcharge Private insurance contributes 7.6%

of total health expenditure Thirty percent of private premiums are paid by the government through a rebate that increases at age 65 In 2009, 44.6% of the population had private insurance Private insurance covers some services that are not covered by Medicare such as optical, physiotherapy, podiatry and dental Private insurance is community-rated and provide by both for and non-profit companies The largest company, Medibank Private, is government-owned, but it operates as a private fund

The hospital sector includes a mix of public (run by the states and territories) and private hospitals In 2006-07, there were 758 public hospitals and 543 private hospitals Public hospitals provided 56,000 beds (67% of the national total) and 26,750 beds (32, 4%) were in private facilities Private hospitals treat 40% of all patients and perform 64% of the elective surgery Private facilities include investor owned and not-for-profit hospitals

Medicare provides free care for patients who elect to be treated as public patients Public hospitals are jointly funded by the governments through five-year agreements The states are fully responsible for public hospitals, sub-acute care

and outpatient services It is up to each jurisdiction to determine how the funding

is allocated to each hospital Each state and territory has it own method for funding individual hospitals, but they generally involve some form of activity-based funding for acute care In January 2009 it was agreed that within five years a nationally consistent approach would be implemented For the first time it will require uniform classification, costing and funding models

Public hospitals also receive income from patients who choose to be private patients The patients that have private health insurance have a wider option of doctors and hospitals Salaried specialists in pubic hospitals are able to treat some private patients, to which they usually contribute a portion of the fees Medicare usually reimburses 85% to 100% of the fee schedule to ambulatory services and 75% of the schedule for in-patient services Doctor’s fees are not regulated Doctors can charge above the fee schedule, or they can treat patients for the cost of the subsidy and bill the federal government directly with no co-payment In 2005 the Medicare payment for certain target populations (low-income, elderly, children and rural) were increased to 100% There is an annual cap on the amount of co-payment that individuals and families pay

Most physicians are in private practice on a fee-for-service basis GPs are gatekeepers, as Medicare will reimburse specialists only for referred consultations Physicians in public hospitals are either salaried (though allowed to have separate private practices and additional fee-for-service income) or paid

on a per-session basis for treating public patients Generally, physicians working

in private hospitals are in private practice and do not concurrently hold salaried positions in public hospitals

Abstracted from:

Australian Private Hospitals Association (2009) Provision of Services in Private

Hospitals Retrieved October 12, 2010, from Australian Private Hospitals

Assocation: of-services-in-private-hospital/

http://www.apha.org.au/media-centre/facts-and-figures/provision-Central Intelligence Agency (2010, November 10) The World Factbook

Retrieved November 27, 2010, from Central Intelligence Agency:

https://www.cia.gov/library/publications/the-world-factbook/

The Commonwealth Fund (2009) The Australian Health Care System New York:

The Commonwealth Fund

World Health Organization (2009) Australia Health System Geneva: World

Health Organization

World Health Organization (2009) Australia: Health Profile Retrieved August

20, 2010, from World Health Organization:

http://www.who.int/gho/countries/aus.pdf

Australia: Programs

Institution Curtin University of Technology School of Public Health

Dept of Health Policy and Management

Program(s)

(1) Post Graduate Diploma in Health Administration (PgradDipHlthAdmin)

(2) Master of Health Services Management (MHSM)

(3) Master of Health Administration (MHA)

Website http://courses.curtin.edu.au/course_overview/postgraduate/Master-HealthAdministration

Address GPO Box U1987, Perth Western Australia 6845

Institution Edith Cowan University Faculty of Exercise, Biomedical and Health Sciences

Health Administration Program

Program(s) (1) Master of Health and Aged Services Management (2) Master of Public Health

(4) *Master of Hospital Administration (MHA) coursework offered through Flinders University at Nankai University in Tianjin, China (5) Master of Science (Health Administration) MSc(HlthAdmin)

(6) Master of Business Administration (Health) (7) Master of Business Administration (Health) (Advanced) (8) Master of Public Health (Health Service Management)

Address

Department of Health Care Management Health Sciences Building (Room 2.31) Flinders University GPO Box 2100

Adelaide SA 5001 Australia

Telephone/Fax Tel: +Fax: +61-8-8201 776661-8-8201 7755

University Contact(s)

Name and Title

Ms Janny Maddern – Head, Department of Health Care Management Prof Judith Dwyer - Head of Research, Department of Health Care Management

Mrs Pam Maslin – Administrative Officer, Department of Health Care Management

Program(s) (1) Master of Health Services Management (2) Graduate Certificate in Health Services Management

(3) Bachelor of Public Health

Address Office of Graduate Studies Nathan Campus

Griffith University

170 Kessels Road Nathan QLD 4111

Telephone/Fax Tel: +61 (0)7 373 55323 Fax: +61 (0)7 373 53885

University Contact(s)

Name and Title Professor Mark Avery Professor Don Steward

Email Mark.avery@griffith.edu.auDonald.steward@griffith.edu.au

Duration of Each

Institution James Cook University Faculty of Medicine, Dept of Public Health and Tropical Medicine

(4) Master of Business Administration and Master of Health

Administration (HZBAHA) (5) Master of Health Administration (HMHA)

University Contact(s)

Name and Title

Prof Stephen Duckett, Dean, Faculty of Sciences (no response from him)

Prof Sandra Leggat

Address

Department of Epidemiology & Preventive Medicine

PO Box 64 Clayton Campus Victoria 3800 Australia

Telephone/Fax Tel: +61 (0)3 9905 1535 or 9905 4313 Fax: +61 (0)3 9905 4302

Country Australia

Institution University of Melbourne School of Public Health

Address University of New England Armidale NSW 2351 Australia

Telephone/Fax Tel: +61 2 6773-3660 Fax: +61 2 6773-3666

University Contact(s)

Name and Title Dr David Briggs – Course Coordinator Prof Steven Campbell – Head School of Health

Duration of Each

(5) Master International Public Health/Master of Health Management (6) Master of Health Administration (MHA)

Website http://www.sphcm.med.unsw.edu.au/http://www.sphcm.med.unsw.edu.au/sphcmweb.nsf/page/Contacts

Address

School of Public Health and Community Medicine Faculty of Medicine UNSW Sydney 2052 Australia

Telephone/Fax Professor MacIntyre Tel: +61 (2) 9385 3811

Email j.Braithwaite@unsw.edu.auhos-sphcm@unsw.edu.au

Duration of Each

Institution University of Queensland Faculty of Health Sciences

(2) Graduate Certificate in Health Services Management

GPO Box 2471 Adelaide SA 5001 Australia

Country Australia

Program(s) (1) Graduate Certificate in Health (Specialization) (2) Graduate Diploma of Health (Specialization)

(3) Master of Health (Specialization)

Duration of Each

Institution University of Western Sydney School of Biomedical and Health Sciences

Address University of Western Sydney Locked Bag 1797

Penrith NSW 2751

Telephone/Fax Tel: + 61 2 9852 5499 Fax: + 61 2 9685 9314