Welcome to the course, Population Health, Governance and Management. My name is Jelmer Schalk. My name is Maarja Beerkens. We both work at Leiden University in the Netherlands, at the Institute of Public Administration. As public administration scholars, we are primarily interested in the organization of health care and the challenges it poses for governments, managers, and professionals. Health has become an increasingly prominent policy sector. It is one of the largest items in the public budget of any country, and increasing health costs are a continuous worry even in wealthy states. Aging population and growing citizen demands on health care challenge us to think how to meet societal expectations of quality and access also in the future. We see the emergence of several chronic diseases, diabetes for example, that require long-term care but also coordination between different health needs and treatments. This pushes us to rethink some care delivery practices. How can we strengthen the integrated people-centred approach for health services? These are examples, some of the governance challenges, and they require action on different organizational levels. First, policymakers and regulators need to create appropriate incentives, set appropriate standards, framework conditions, and accountability mechanisms. So, the governance of the health care system as a whole is crucial. Second, health organizations operating in these systems must be able to adapt and change. Effective management and coordination of tasks and services within and between organizations critically affects health outcomes. Third, the role of health care professionals is vital. They need to adjust their practices and ways of working. This is what governance is about. How our health system is organized and steered at multiple levels. We must recognize that it is not only the role of government to make a health system work with an appropriate funding and policy framework, or only after health providers to offer a good service. It is about interdependencies between different actors, public and private, formal and informal, service providers, regulators, patients, funders. It is a complex system. No wonder that key organizations such as the World Health Organization and OECD, emphasize the necessity for good health governance, in order to achieve good health outcomes. Throughout the course, we will emphasize the importance of different organizational layers and their interdependencies. We will discuss how you, either current or future health professionals, managers, leaders, can make sense of a changing health governance system from state-wide policy shifts to organizational adaptation, and how to act on it. The course consists of four modules, all representing a different organizational layer. In module one, we focus on health systems as a whole, how are they organized and steered? In module two, we descend to the level of organizations or health care providers. In module three, the focus shifts to networks or collaborations between health care and other organizations that jointly aim to improve health services. Then the fourth and last module, we go a layer deeper and focus on professionals, such as nurses, doctors, and health practitioners more generally. To summarize, this course gives you an overview of how health systems are governed, and how you as a manager or professional can face some of the governance challenges. It would be impossible to treat every governance and management issue in depth, and our overview is necessarily brief. Our aim, is to let you appreciate the complexities of health care and governance from a multi-level perspective, and to stimulate you to explore further. For each topic we present in this course, we will suggest further readings and course material for a more in-depth understanding. We are glad you share our enthusiasm for the complex world of health governance, and we hope to see you soon in module one.
