CPH 310: Health Care in the US SYLLABUS Fall 2012 Time: Tuesdays and Thursdays, 11:00-12:15 pm Location: Drachman Hall A114 Instructor: Joe K. Gerald, MD, PhD A227 Drachman Hall geraldj@email.arizona.edu (520) 626-4678 Teaching Assistants: Office Hours (Dr. Gerald): (TA hours): Andrew Campos Joni Dean Alyssa Padilla Tuesdays and Thursdays 12:30 1:30 pm and by appointment TBA Course Description: This course describes the structure and function of the various private and public health care entities within the United States. Strengths and weaknesses related to cost, quality and access are analyzed. Basic economic theories that drive financing are also considered. Course Prerequisites: None Course Learning Objectives: Upon completion of this course students will be able to: Define and explain the major individual, cultural and national principles that govern the provision of health care services. Compare and contrast the structure, delivery and financing of health care in the US and other industrialized nations. Compare and contrast the cost, quality and access of health care in various industrialized and non-industrialized nations. Describe the education, training, credentialing and continuing education requirements of physicians and non-physician midlevel providers in the US. Compare and contrast the delivery of health services for chronic and acute conditions. Compare and contrast cost, access and quality of out-patient, in-patient and long-term care. Describe the sources of health care financing and the distribution of health expenditures. Compare and contrast payment systems such as fee-for-service, restricted provider networks and capitation. Describe the role of government in the financing and delivery of health care services. Explain eligibility for and benefits provided by Medicare Parts A, B and D. Explain eligibility for and benefits provided by Medicaid.
Define health disparity, inequity and vulnerable population and describe reasons for dissimilar health outcomes across various populations. Explain how the government formulates and enacts health policy. Explain how economic theory predicts the supply, demand and consumption of health care. Define health quality and state strengths and weakness of various measurement strategies. Describe the impact of health technology on cost and delivery of health care services and the relationship between health technology and improved health outcomes. Undergraduate Competencies Distinguish between the roles that morals, ethics and law have on public health. Explain basic concepts of public health administration and its affect on society. Course Notes: Power Point lectures and additional required and supplemental reading will be available on the course web-site at http://d2l.arizona.edu/. Required Texts/Readings: (1) Donald Barr, MD, PhD. Introduction to US Health Policy: The Organization, Financing, and Delivery of Health Care in America (3 rd edition, paperback). Baltimore: Johns Hopkins, 2011. (2) Additional required readings are available at the course web-site http://d2l.arizona.edu/ Course Requirements: To successfully complete this course, students must demonstrate understanding of the course material (lecture material and assigned reading) via examinations that may be comprised of single best-answer multiple-choice, short-answer and discussion questions. Students must also demonstrate the ability to research, analyze and synthesize information via weekly writing assignments. Grading: There will be 4 exams during the semester and an optional comprehensive final exam on Tuesday, December 11th, 2012 at 10:30am-12:30pm. The final examination is optional and cannot lower a course grade. There are a total of 6 written homework assignments during the semester; 3 are due prior to the second exam and 3 more are due prior to the fourth exam. If more than 3 assignments are turned in during either the first or second half sessions, only the 3 highest grades will be counted. While course attendance will not be recorded, unscheduled extra-credit assignments will be offered during scheduled class times during the semester (12 points max). The final course grade will be determined as follows: Assignments Grading Scale Exam 1: 40 pts A 89.5% - 100% Exam 2: 40 pts B 79.5% - 89.4% Exam 3: 40 pts C 69.5% - 79.4% Exam 4: 40 pts D 64.5% - 69.4% Final Exam: 50 pts optional E< 64.5% Homework: 150 pts Total: 360 pts Assignment Descriptions: Homework: Six total assignments are required over the course of the semester. Students must complete at least 3 (1.1-1.6) assignments before Exam 2 and 3 additional assignments (2.1-2.6) Revised 8/22/2012 Page 2 of 6
after Exam 2. Each assignment is worth a maximum of 20 points. If students complete more than 3 assignments in any half, the highest 3 grades will be used. To receive full credit for the assignment, students must: Compose 400-500 word response. The word count o must be clearly documented at the end of the text o does not include the title or reference list, but does include in-text citations Font must be 12 pt, line spacing must be double-spaced, margins must be at least 1 inch References should be documented using endnotes (see JAMA or NEJM for examples) or APA style (in-text) citations. A reference list must be included using either style. o o Any required reading, including the textbook, must be clearly referenced. In addition to any required reading, at least 1 additional article indexed in PubMed must be used to support your response. Recommended journals: JAMA, NEJM, Health Affairs, Health Services Research, and American Journal of Public Health. Examinations: The course examinations may consist of single best answer multiple-choice questions, matching, true/false, short answer and discussion questions. Questions will be derived from the required readings and lecture material. No make-up examinations will be offered. If any exam is missed, the final exam must be taken. The final exam grade will be substituted for the missed exam grade. Class Attendance/Participation: Class attendance is a critical component of the learning experience. Important concepts from the reading and outside materials will be explained and critically analyzed. While class attendance will not be routinely monitored, unscheduled extra credit assignments will be offered during class hours over the course of the semester (12 points max). All holidays or special events observed by organized religions will be honored for those students who show affiliation with that particular religion. Absences pre-approved by the UA Dean of Students (or Dean s designee will be honored.) Required Statements: Communications: You are responsible for reading emails sent to your UA account from your professor, the teaching assistant and announcements that are placed on the course D2L web site. Information about readings, news events, your grades, assignments and other course related topics will be communicated to you with these electronic methods. The official policy can be found at: http://www.registrar.arizona.edu/emailpolicy.htm Disability Accommodation: If you anticipate issues related to the format or requirements of this course, please meet with me. I would like us to discuss ways to ensure your full participation in the course. If you determine that formal, disability-related accommodations are necessary, it is very important that you be registered with Disability Resources (621-3268; drc.arizona.edu) and notify me of your eligibility for reasonable accommodations. We can then plan how best to coordinate your accommodations. The official policy can be found at: http://catalog.arizona.edu/2011%2d12/policies/disability.htm Revised 8/22/2012 Page 3 of 6
Academic Integrity: All UA students are responsible for upholding the University of Arizona Code of Academic Integrity, available through the office of the Dean of Students and online: The official policy found at:http://dos.web.arizona.edu/uapolicies/scc5308abcd.html and http://dos.web.arizona.edu/uapolicies/cai1.html. Classroom Behavior: Students are expected to be familiar with the UA Policy on Disruptive Behavior in an Instructional Setting found at http://web.arizona.edu/~policy/disruptive.pdf and the Policy on Threatening Behavior by Students found at http://web.arizona.edu/~policy/threatening.pdf Grievance Policy: Should a student feel he or she has been treated unfairly, there are a number of resources available. With few exceptions, students should first attempt to resolve difficulties informally by bringing those concerns directly to the person responsible for the action, or with the student's graduate advisor, Assistant Dean for Student and Alumni Affairs, department head, or the immediate supervisor of the person responsible for the action. Grade Appeal Policy: http://catalog.arizona.edu/2008%2d09/policies/gradappeal.htm Syllabus Changes: Information contained in the course syllabus, other than the grade and absence policies, may be subject to change with reasonable advance notice, as deemed appropriate. Updates will be clearly noted on the course D2L home page. Telephone and Computer Use: Laptops are allowed and use is governed by the following University policy Policy Title: Acceptable Use of Computers and Networks at the University of Arizona. Turn your cell phones to silent or vibrate in order to not disrupt the class and disturb your fellow students and professor. Revised 8/22/2012 Page 4 of 6
Date Aug 21 (T) CPH 310: Course Schedule Fall 2012 Lecture Topic Course Expectations and Syllabus Aug 23 1 US Health Care System w/emphasis on Cost Aug 28 (T) 2 Brief History of Medicine and Health Insurance Assign Due Aug 30 3 Increasing Life Expectancy: the Promise and Reality of Aging 1.1 Sept 4 (T) 4 Individual Determinants of Health Sept 6 5 Social Determinants of Health 1.2 Sept 11 (T) 6 The Role of Public Health Sept 13 7 Disease Prevention and Health Care Costs 1.3 Sept 18 (T) EXAM 1 EXAM 1 Sept 20 1 America s Unique Values Create Difficult Challenges Sept 25 (T) 2 The Structure and Function of the US Health Care System Sept 27 3 Primary (Outpatient) and Tertiary (Hospital) Care 1.4 Oct 2 (T) 4 Health Care Workforce: Physicians Oct 4 5 Health Care Workforce: Nurses and Physician Assistants 1.5 Oct 9 (T) 6 Principles of Health Insurance Design Oct 11 7 Employer-Based Health Insurance and Managed Care 1.6 Oct 16 (T) EXAM 2 EXAM 2 Oct 18 1 Government Programs: Medicare 2.1 Oct 23 (T) 2 Government Programs: Medicaid Oct 25 3 Ensuring the Sustainability of Government Programs 2.2 Oct 30 (T) 4 The Health Care Safety Net and the Uninsured Nov 1 5 The Challenge of Long-term Care 2.3 Nov 6 (T) EXAM 3 EXAM 3 Nov 8 1 Health Policy and the Political Process 2.4 Nov 13 (T) 2 Tax Policy and Health Care Nov 15 3 An International Perspective of Health System Design 2.5 Nov 20 (T) 4 The Patient Protection and Affordable Care Act Nov 22 THANKSGIVING BREAK No Class Nov 27 (T) 5 The Expected Impact of the Affordable Care Act Nov 29 6 Medical Malpractice, Defensive Medicine, and Tort Reform 2.6 Dec 4 (T) EXAM 4 EXAM 4 Dec 11 Final Exam (Drachman A114 10:30-12:30) FINAL Revised 8/22/2012 Page 5 of 6
CPH 310 Plagiarism Policy In this course, students are required to complete weekly writing assignments on current topics related to the delivery of health care in the United States. It is expected that all students will abide by the highest principles of academic integrity when completing these assignments. Given that students are expected to use multiple externals sources including textbooks, journals, newspapers, and web-sites, properly acknowledging the use of these resources is an important consideration for their writing. All of the following acts are considered to be plagiarism (from www.plagiarism.org): turning in someone else's work as your own copying words or ideas from someone else without giving credit failing to put a quotation in quotation marks giving incorrect information about the source of a quotation changing words but copying the sentence structure of a source without giving credit copying so many words or ideas from a source that it makes up the majority of your work, whether you give credit or not Students may elect to complete the on-line plagiarism workshop offered by the University of Indiana. It may be accessed at https://www.indiana.edu/~istd/. Initial each line to indicate that you have read and understood each statement. I understand that each written assignment for this class will be evaluated using TurnItIn.com. I understand that a first act of plagiarism will result in loss of credit for the assignment, a 10% reduction in the course grade, and mandatory completion of the University s plagiarism workshop. I understand that a second act of plagiarism will resort in a course grade of E. Student Signature Date Signed Revised 8/22/2012 Page 6 of 6