ERASMUS KA 2 PROJECT Enhancement of study programs

ERASMUS+ KA 2 PROJECT: Enhancement of study programs in Public Health Law, Health Management, Health Economics and Health Informatics in Montenegro Meeting in Podgorica 17 -20 th October Montenegro Project web site: www. ph-elim. net

ERASMUS+ KA 2 PROJECT: Enhancement of study programs in Public Health Law, Health Management, Health Economics and Health Informatics in Montenegro New /updated courses at UNIM Doc. dr Anđela Jakšić Stojanović & doc. dr Marija Janković . Project web site: www. ph-elim. net

Existing courses Public health lectures at the Mediterranean University are based on the description of activities on the very explicit identification of the integrated knowledge, skills and values that are needed in this field. The content of these lectures is based on what students need to know and what they should be able to do, as determined according to the needs of students and society. Learning outcomes on subjects in these areas are based on a careful and broad analysis of what a competent person should do in different contexts. Learning should be relevant to the various roles of the individual, including the roles in work, social and private life. There are the following subjects in these areas at the Faculty of Tourism and Hospitality: Medicine and Tourism, Principles of Nutrition, Food Preparation and Welness and Spa, while the Faculty of Law has the subject of Judicial Medicine.

I: Medicine and Tourism Within the subject Medicine and Tourism, the following areas are studied: Introduction to tourism medicine, the significance of climate, physical and epidemiological impacts on the health of tourists Infectious diseases and tourism The meaning of urgent medicine in tourism and cardiovascular disease More common gastrointestinal diseases Intoxicants to various agents Skin diseases related to tourism medicine Diseases and conditions related to accidents at sea More often tourists hurt

Principles of Nutrition Within the course of the Principles of Nutrition, among others, the following areas are studied: Nutritional substances, their role. Macro-nutrients: Carbohydrates, fats and proteins Micro-nutrients: vitamins and minerals. The role of vitamins and minerals in the body and diseases that result from insufficient input. Nutrient nutrition. Supplements and additives in nutrition. Metabolic reactions in the body. Determining individual energy needs. Energy metabolism. Evaluation of nutrition. Nutrition disorders: obesity and anorexia Planning a daily menu Nutrition of patients with heart disease, gastrointestinal tract, kidney, liver, pancreas. Diet of anemia and diabetes. Energy metabolism.

Food Preparation Technology In the course of Food Preparation Technology, students learn: Basic food preparation processes - mechanical (washing, cleaning, grinding, crushing, peeling), thermal (blanching, cooking, ironing, baking, frying), cooling (freezing), Importance and role of flavour correction, hydrocolloids, antioxidants and preservatives in food preparation Types of meals. Menu Food preparation system Planning and organizing various food preparation systems and their division Catering Technique of handling food products in warehouses, transport and food preparation Levels of processing of food products and their technological and economic significance.

Wellness and SPA Within the Wellness and SPA course, students study the following topics: Reception business of Wellness & SPA Code of Conduct and Hygiene of Space Procedures on standards of behaviour and dressing. Information on status and on current events in Wellness & SPA Software programs for Wellness & Spa Organizational chart in Wellness & SPA and hotel - Organization and supervision of hygienists and auxiliary workers in Wellness & SPA

Forensic Medicine The following areas are studied in the field of Forensic Medicine: Forensic autopsy, reasons for indication Pathology of traffic injuries Thermal injuries; Death in a fire Sexual violence and rape Injury injuries by harsh means Medical practice and penalties Abuse of children Deaths due to taking drugs Going to the place of death, signs of death, time of death, forensic autopsy.

New courses: Health Management and Health Economics Marketing management and Financial Management courses • Graduate studies: Elective subjects: (Marketing management) 1. Media Communications in Health Care Institutions 2. Brand Management of Health Care Institutions Graduate studies: Elective subjects: (Financial management) 1. Management in the Health Care System 2. Financial Planning in the Health Care System Specialists studies: Elective subjects: (Marketing management) 1. Marketing in Health Care 2. Public Relations in Health Care Specialists studies: Elective subjects: (Financial management) 1. Financial Management in Health Care Institutions 2. Financial Control and Evaluation in Health Care Institutions

II Health Management and Health Economics Master studies (Elective subjects: Financial Management) 1. Financial Reporting in Health Care Institutions 2. Evaluation of Organization Master studies (Elective subjects: Marketing Management) 1. Holistic Marketing in Health Care System 2. Integrated Marketing Communications of Health Care Institutions

TEACHING PROGRAM DESCRIPTION Since the health care sector as a whole is facing increasing demand, the ability to identify and meet effectively users’ needs and expectations is paramount for any healthcare organization. This is needed not only by private healthcare providers in order to ensure financial viability, but also by public providers, in order to guarantee consensus. On the background of this development, the courses aim to provide students with the basic knowledge and skills needed to manage the marketing and financial function in health care organizations, as well as to understand the dynamics of marketing and management and social advocacy. A special focus will be placed on the development of marketing and financial plans coherent with the specific environment of different healthcare services, since they are integral to the development and implementation of successful strategic plans, and on the importance of communication for healthcare organizations, which is vital to ensure an effective fit with the expectations of external stakeholders.

Program objectives The objective of this course is to provide students with the necessary knowledge and skills required to appreciate, evaluate and apply marketing and management theory, concepts and tools to Montenegrian healthcare organizations in general, and their own sphere of professional and managerial practice in particular. In overall terms, students will better understand the key principles and practical implications of a demand-based approach to health management and be able to relate and apply these in their own work environment.

Learning outcomes Upon successful completion of the course, students should be able to: understand the features of marketing and financial management in healthcare organizations, and the steps by which it helps an organization identify the needs of and focus on its customers; identify health marketing environmental, customer and competitive issues, and know how the variables of the “marketing mix” must be adapted to address the peculiar challenges of marketing healthcare products and services; draft a marketing and financial plan suitable for inclusion in a broader strategic plan, including both demand analysis and recommendations for the definition of an appropriate product mix; understand the importance of communication in healthcare organizations and contribute to the design of communication campaigns using social marketing techniques, both addressing individual behaviour and public will.

Teaching time and methods Total of one hundred and fifty hours (150 hrs): fifty seven hours (57 hrs) under supervision and ninety three hours (93 hrs) for individual work. Fifty seven hours (57 hrs) under supervision consist of thirty hours (30 hrs) devoted to lectures, twenty four hours (24 hrs) devoted to advisory support by the instructors to the preparation of the final assignment and three hours (3 hrs) devoted to a review of the course topics and a clarification of questions and doubts prior to the final exam. Ninety three hours (93 hrs) will be for course work without supervision. Students are expected to participate actively in course (preparing for lectures, seminars and exercises, doing necessary homework and carrying out the appropriate assignments). Each course comprises 150 hours: 55 hours (± 3 hours) active teaching. That includes 30 hours lecturing plus 22 -28 hours e-learning, consultation and others. The rest of the hours are without supervision.

Means of evaluating student performance Evaluation will be based upon: 10% participation (attendance, discussion of readings, participation in small group and individual work). Several times throughout the course, cases will be circulated or posted on the web-site; these cases will form the basis for class discussions on the date assigned. 60% final assignment, to be developed throughout the course. The final assignment is a comprehensive marketing and financial plan for a Montenegrian healthcare organization, a unit there of or a specific service, including a section devoted to demand analysis and segmentation and a communication plan. The evaluation of each part will weigh 20% of the final grade. The plan will have to be developed by groups of two students, although exceptions can be granted to students who wish to work on an individual basis. 30% final exam. The final exam will have five multiple-choice questions (each answer weighting 2% of the final grade) and four open-ended questions (each answer weighting 5% of the final grade).

Examples: Results of a survey in the Italian National Health System Corporate marketing Competitive positioning 44% Local Health Authoritie s Sector-wide marketing Support to health policy implementation 19% Brand marketing Social marketing Promotion of the brand 61% Health education campaigns 78% Promotion of the brand 78% Health education campaigns 47% Hospital Trusts Competitive positioning 66%

Challenges to the adoption of a marketing orientation • Corporate marketing • Difficulties in segmentation and positioning, since often profitability cannot be used as a benchmark (for political and technical reasons) • The complexity in the relationships with patients is often overlooked • Sector-wide marketing • Problems in joint planning • Difficult identification of criteria for priority-setting • Equity is a key goal ( measurement problems)

Challenges to the adoption of a marketing orientation (2) • Brand marketing • Poor link between communication and actual service delivery patterns ( risk of unmet expectations) • Limited or no involvement of professionals • Social marketing • Operational orientation: objectives are already given • Core activities are overlooked • No specification of organizational responsibilities and milestones

The marketing process in Health Organizations Individual Corporate Direct Indirect Demand Analysis Competitors Current and potential Segmentation Strategy Product / market matrix Targeting Implementation Control Market research Product People Place Process Price Physical Promotion evidence Marketin g mix Revenues, margins, etc. Patients’ satisfaction Brand equity

Why demand analysis is relevant • The purpose of health care marketing is to aim at customer satisfaction to gain a competitive advantage or to meet patients’ expectations • This goal can not be reached without a deep knowledge about demand; a sound demand analysis is especially important when • competition is intense (“exit”) • customers are sophisticated and demanding (“voice”) • dynamic change is the rule rather than the exception

Demand analysis in health care • Need vs. demand vs. use • Information asymmetry (ethical issues regulation) • The efforts to understand need and predict demand rely on critical assumptions • nature of the goods and services users want from their health system • bases upon which users make consumption decisions • extent to which they are in control of those decisions

Demand analysis and features of the health care system • Individual users do not act alone: their choices are influenced by the actions of other influential groups, complicating the decision-making process: • health services providers • third-party payers (insurance companies, Ministries, employers, charities, international organizations, etc. ) • Each player makes decisions that will influence the other, usually using different and conflicting criteria

Patients as customers • Patients are a heterogeneous group with different values and decision criteria ( need for segmentation) • Decision-making processes are extremely different depending on the product or service patients are seeking • voluntary or compulsory health insurance • health services provider (physician or hospital) • medications and therapies

Patients as customers (2) • Patients tend to value • relationship with physician (USA: 60% of Medicare beneficiaries changed health plans to maintain physician relationship) • opinions of friends and family: word of mouth is seen as more trustworthy than summary satisfaction scores • BUT are more well-informed about available options, and less willing to give exclusive control of care over to their physician (“consumer-driven healthcare” / patients’ rights movement)

Gap analysis (2) • Total market gap = overall theoretical demand – total existing demand • Market gap for a given organization = market potential – satisfied demand • The market gap for a given organization can be broken down into three main components: • non-users of the product or service • “light” users (only sometimes or consumption of small amounts anytime) • users of competitors’ products or services

Bangladesh: reported reasons for not seeking care in obstetric emergencies • Unable to identify emergency problems (59, 5%) • Financial costs are relatively high (45, 5%) • Unaware of the availability of specific services at the facility (39, 3%) • Required medicines not always available (38, 2%) • In-laws object (35, 6%) • Religion does not allow to leave the house, especially during pregnancy (35, 3%)

Bangladesh: reported reasons for not seeking care in obstetric emergencies • Shyness (32, 3%) • Facility too far from home (28, 3%) • Doctor not available when needed (25, 2%) • Poor communication facilities (17, 8%) • Husband objects (17, 0%) • Difficult to get admission (14, 1%) • Unfriendly attitude of service providers (5, 6%) (Barkat et al. 1995; multiple answers possible)

III Public Health Law: Elective subjects • Legal regulations in the health care system • Moral aspects in the health care system • Legal protection of health care users • Legal protection of the psycho-social aspect of the person in the health care system • Social-responsible aspects of health care • Protection and rights of the family in health care

ERASMUS+ KA 2 PROJECT: Enhancement of study programs in Public Health Law, Health Management, Health Economics and Health Informatics in Montenegro New /updated courses at UNIM Doc. dr Anđela Jakšić Stojanović & doc. dr Marija Janković Thank you for your attention . Project web site: www. ph-elim. net