Management Designs😊

Health Management Techniques

• Health Management: Effective use or management of resources.

Quantitative	Qualitative (Based on Behavioral Sciences)
• Cost-benefit analysis	Mnemonic: POCIMon
• Cost-effective analysis	• Personal management
• System analysis	• Organizational design
• Cost accounting	• Communication
• PPBS: ↳ Planning, Programming, and Budgeting System	• Information system
• Work sampling	• Management by objectives
• Network analysis	ㅤ
• Decision making	ㅤ
• Input-output analysis	ㅤ
• Model	ㅤ
ㅤ	Vaishna: Personal, organise, communicate, Information, Objective → medicine But not decision making

Qualitative

• Organisational designs

• Personnel management

• Communication

• Information systems

• Management by objectives

Quantitative

• Network Analysis:
• Program Evaluation and Review Technique (PERT):
• Sequence of events (e.g., A -> B, B -> C, D --> E)

• Critical Path Method (CPM):
• Critical path: Event that takes the longest time.
• Use: Assess shortest time to complete the program.

• Cost Analysis:
• Cost benefit
• Return of benefit in terms of money/finance.
• Cost effective
• Return of benefits in terms of lives affected (saved).
• ICER (Incremental Cost-Effectiveness Ratio) is used in cost effective analysis
• e.g. National Health Programme uses cost-effective analysis.

• Stock Analysis / Inventory Control
• ABC/VED analysis
• For delegating purchase power for commodity in an organisation:
• ABC: Based on cost of commodity.
• A – Extremely important (vital)
• B – Moderately important (essential)
• C – Relatively unimportant (desirable)
• VED: Vital Essential Desirable use of the commodity.
• Vital
• Example: Anti-snake venom
• Essential
• Example: Higher antibiotics
• Desirable
• Example: PCM, ORS

1. Input–Output Analysis

2. Cost Accounting

• Focuses on:
• Cost structure
• Resources used
• Cost control
• Reimbursements

3. PPBS (Planning, Programming, and Budgeting System)

• Used for: Planning program budgets

• Method:
• Zero-base budgeting
→ Every year, a fresh budget is allocated (no carry-over)

4. Work Sampling

• What:
• Systematic recording/reporting of health worker activities

• Who:
• Doctors, Nurses, Lab technicians

• Why:
• To increase output and improve efficiency

Legislative Section Lists

Newer Initiatives by MoHFW

Ayushman Bharat Scheme

 

1. PMJAY (Pradhan Mantri Jan Arogya Yojna):

• Aka National Health Protection Mison

• World’s largest health insurance scheme.

• ₹5 lakh to 10 crore families.

• Beneficiaries: ~50 cr population.

• Blanket coverage (Irrespective of age, type of disease etc).

2. Comprehensive Primary Health Care (CPHC):

• Health & Wellness Centre-Sub-centre set up

• Aka Arogya Mandir

• Under New Indian Public Health standards.

• Officer: Community Health Officer (CHO).
• Nodal officer for HWC (Health & Wellness Centre).
• Qualification: Nurses
• Functions: Diagnosis, treatment, maintenance of medical records.

• Functions:
• Comprehensive primary health care
• At subcentre >>>
• At PHC
• Continuum of care:
• Diagnostic, therapeutic, preventive, promotive.
• <30 min: Time to care.
• ABHA ID:
• Centralised ID for all medical records.

• In addition to CHO → New IPHS guidelines:
• Pharmacist & Lab technician
• 1 per 10,000 population (At sub-centre level).
• To help CHO diagnose and Rx
• Ophthalmologist:
• 1 per 3 to 5 CHCs.
• They are less in number → so relaxed norms

Schemes for Social Health

Miscellaneous Topics

Essential medicines

• Monitored by CDSCO (Central Drug Standard Control Organization).

• Head office: New Delhi (6 zonal offices).

The Drugs and Cosmetics Act

• Regulates import, manufacture, distribution, and sale of drugs.

Medical products	Meaning
Misbranded Drug/ Counterfeit	• Intentionally made to deceive. • Not labelled correctly, or label makes false claims. • A drug stating 500mg of paracetamol per tablet but containing only 200mg is a misbranded drug.
Sub-standard/ Out of specification	• Authorized medical products that do not meet quality standards.
Falsified/ Spurious Drug	• Deliberately misrepresent identity or source of composition. • Imitation or substitute, deceptive name • (e.g., small company imitating known brand). • Punishable: Life Imprisonment • Furious → Imprison for life • North indian companies making fake branded products
Unregistered	• Not evaluated or approved.
Adulterated Drug	• Contains filthy, putrid, or decomposed substances.

Health Budget 2023-2024

1. Launch of new medical & nursing colleges.

2. Sickle cell anemia elimination (in tribal areas).

3. To promote research & innovation in pharmaceuticals.

4. Multidisciplinary course for medical devices to be supported in existing institutions.

5. ↑ GDP spending on health to 2.1% (Target: >2.5%).

Health Policy Indicators

• Every country should spend 5% of GDP on health, according to WHO

Q. All are disability indicators except:

NOTE

OTTAWA RULES:

• When to take Xray in ankle trauma

• M/c injury → Anterior Talofibular Ligament tear

Ottawa Convention (Mine Ban Treaty)

• 1997 treaty.

• Bans use, stockpiling, production, transfer of anti-personnel landmines.

• Requires:
• Destruction of stockpiles within 4 years.
• Clearance of mined areas within 10 years.
• Assistance to victims.

• Not signed by:
• USA
• Russia
• China
• India
• Pakistan

Tillaux #

• Distal tibia → salter haris 3

• Avulsion fracture

DANIS- WEBER classification:

• For ankle #

Dancers # → Pseudo jones

Jumpers # → Sacrum

Denis classification

Judet and letournel: Acetabulum #

Young and Burgess: Pelvic #

Schatzker classification: Tibia #

EVANS CLASSFICATION → IT #

Economics

• Gross domestic product (GDP):
• Gross income generated within a country only
• excludes net income received

• Gross national income (GNI) or Gross national product (GNP)
• Gross income generated from within the country +
• net income received from abroad

• Net national product (NNP):
• GNP minus capital we consume
• NN - Negetive

ICD-11

• 3 volumes.

• Arabic numbered chapters.

• 4 categories with 2 subcategories.

• 26 chapters: New chapters on
• Sleep wake disorders
• Immune mediated disorders

Employee State Insurance (ESI) Scheme

General Features

• Under the Ministry of Labor.

• Managed by ESI corporation.

• Established on 24th February, 1948 (ESI day).

• Eligible organizations:
• All organizations are under ESIC.
• Exceptions: Defence, mines, railways, central government.

• Contribution:
• 4% total wage paid monthly to ESIC.
• Employee: 0.75% of wage.
• Employer: 3.25% of employee's wage.

• Eligible beneficiaries:
• Monthly salary of < Rs. 21,000/month.
• If physically handicapped < Rs. 25,000/month.

Benefits

• Indirect: By empanelled hospital facilities.

• Direct: By ESI hospital/clinics.

Shramnik Kalyan Yojna

• Under ESI

• Unemployment protection scheme for:
• Retrenchment (Lay off).
• Forceful closure of company.
• Non occupational injury.

• Benefit: Up to 50% wage x 2 yrs.

Factories Act (1948)

• Permissible hours of work:
• <48 hrs/week
• < 9hrs/day
• With overtime: <60 hrs/week

• Notifiable diseases - 29
• Not included → Bagassosis

• NOTE:
• Article 21: Right to life

Age	Employment
<14 years	Not to be employed (Article 24)
15-19 years (Tender age)	Appropriate work only (Article 39) • 4.5 hrs/ day (6am - 7pm) • No night duty • No overtime • No hazardous work • 1 extra leave every 14 days

Facilities

Employee	Mandatory features
>50	Creche facility
>250	Food facility
>500	Welfare officer
>1000	Safety officer

 

Healthcare Committees

Swasth Nari Sashakt Parivar Abhiyan

• Theme: Healthy Women, Empowered Families

• By Ministry of Health and Family Welfare

• Linked to 8th Rashtriya Poshan Maah (Nutrition Month)

• Implementation sites
• Ayushman Arogya Mandirs
• Community Health Centres
• District Hospitals
• Other government health facilities

• Objectives
• Improve nutrition
• Increase health awareness
• Enhance overall well-being
• Women
• Children

Mission Shakti

• For women empowerment
• Under Ministry of Women & Child Development.
• Sambal: Safety & security of women.
• Samarthya: women empowerment.
• Includes
• Ujjawala
• Pradhan Mantri Matru Vandana Yojana
• Swadhar Greh & National Creche Scheme.