Course Description
| Course | Code | Semester | T+P (Hour) | Credit | ECTS |
|---|---|---|---|---|---|
| HEALTH INSURANCE | SKİ2248610 | Spring Semester | 2+0 | 2 | 5 |
| Course Program | Salı 11:00-11:45 Salı 12:00-12:45 |
| Prerequisites Courses | |
| Recommended Elective Courses |
| Language of Course | Turkish |
| Course Level | Short Cycle (Associate's Degree) |
| Course Type | Required |
| Course Coordinator | Assist.Prof. Uygar ÜSTÜN |
| Name of Lecturer(s) | Assist.Prof. Uygar ÜSTÜN |
| Assistant(s) | NONE |
| Aim | To provide the students with the main scope of health insurance and its importance in health management. |
| Course Content | This course contains; Major Finance Models of Health System and Role and Importance of Insurance,Health Insurance Terminology and Classification,Analysis of Private Health Insurance Market by Historical, Technical and Distribution Channels in Turkey,Main Regulatory Frame Work of Private Health Insurance (PHI),Main Regulatory Frame Work of Social Health Insurance (SHI),Organizational Structure, Underwriting and Production Processes of PHI-I,Organizational Structure, Underwriting and Production Processes of PHI-II,Claims and Preauthorization Processes of PHI,Network and Contract Management at PHI,Sustainability for Health Expenditures: Payment Systems and Financial Tools for Chronically Diseases,Complementary and Supplementary Health Insurance (CSHI),Tourism, Health and Insurance,Analyzing Health Data and Strategic Targets-I,Analyzing Health Data and Strategic Targets-II. |
| Dersin Öğrenme Kazanımları | Teaching Methods | Assessment Methods |
| 1. Will be able to interpret health system from macro financial perspective by | 10, 16, 9 | A, E |
| 1.1. Classifying economical systems and major sources | 10, 16, 9 | A, E |
| 1.2. Explaining roles and importance of a variety of financial sources | 10, 16, 9 | A, E |
| 1.3. Defining health expenditure by source and distribution | 10, 16, 9 | A, E |
| 1.4. Explaining importance of sustainable finance system for health expenditures | 10, 16, 9 | A, E |
| 2. Will be able to explain insurance and related subjects by | 10, 16, 9 | A, E |
| 2.1. Clarifying major insurance concepts | 10, 16, 9 | A, E |
| 2.2. Differentiating social and private insurance | 10, 16, 9 | A, E |
| 2.3. Expressing main work frame of insurance system | 10, 16, 9 | A, E |
| 3. Will be able to discuss social and private health insurance by | 10, 16, 9 | A, E |
| 3.1. Explaining information on social health insurance system | 10, 16, 9 | A, E |
| 3.2. Identifying organizational and functional structure of private insurers and their relationships with healthcare providers | 10, 16, 9 | A, E |
| 3.3. Refining regulation, organization and functional structure of general health insurance | 10, 16, 9 | A, E |
| Teaching Methods: | 10: Discussion Method, 16: Question - Answer Technique, 9: Lecture Method |
| Assessment Methods: | A: Traditional Written Exam, E: Homework |
Course Outline
| Order | Subjects | Preliminary Work |
|---|---|---|
| 1 | Major Finance Models of Health System and Role and Importance of Insurance | A literature review about the subject |
| 2 | Health Insurance Terminology and Classification | A literature review about the subject |
| 3 | Analysis of Private Health Insurance Market by Historical, Technical and Distribution Channels in Turkey | A literature review about the subject |
| 4 | Main Regulatory Frame Work of Private Health Insurance (PHI) | A literature review about the subject |
| 5 | Main Regulatory Frame Work of Social Health Insurance (SHI) | A literature review about the subject |
| 6 | Organizational Structure, Underwriting and Production Processes of PHI-I | A literature review about the subject |
| 7 | Organizational Structure, Underwriting and Production Processes of PHI-II | A literature review about the subject |
| 8 | Claims and Preauthorization Processes of PHI | A literature review about the subject |
| 9 | Network and Contract Management at PHI | A literature review about the subject |
| 10 | Sustainability for Health Expenditures: Payment Systems and Financial Tools for Chronically Diseases | A literature review about the subject |
| 11 | Complementary and Supplementary Health Insurance (CSHI) | A literature review about the subject |
| 12 | Tourism, Health and Insurance | A literature review about the subject |
| 13 | Analyzing Health Data and Strategic Targets-I | A literature review about the subject |
| 14 | Analyzing Health Data and Strategic Targets-II | A literature review about the subject |
| Resources |
| Türkiye'de Sağlık Sigortası, Siyasal Kitabevi, Emine Orhaner, 2018 |
Course Contribution to Program Qualifications
| Course Contribution to Program Qualifications | |||||||
| No | Program Qualification | Contribution Level | |||||
| 1 | 2 | 3 | 4 | 5 | |||
| 1 | Knows how to access current basic, theoretical and applied scientific knowledge in the field of Health Institutions Management by using information technologies and resources; evaluates the accuracy, reliability and validity of this information. | X | |||||
| 2 | Recognizes the subdivisions of the health system organization and the employees working in these departments, has knowledge about the duties, authorities and responsibilities of the employees, plans, organizes and directs the performance of health service providers. | ||||||
| 3 | Uses basic theoretical and practical knowledge, basic computer programs and related technologies related to the field of Health Institutions Management. | ||||||
| 4 | To be able to carry out a given task independently using the basic knowledge in the field of Health Institutions Management. | ||||||
| 5 | Evaluates the basic knowledge and skills acquired in the field of Health Institutions Management with a critical approach; identifies learning needs and directs learning. | X | |||||
| 6 | Uses information and communication technologies together with computer software at least at the basic level of European Computer Driving License required by the field of Health Institutions Management. | ||||||
| 7 | The student complies with and contributes to quality management and processes. | X | |||||
| 8 | The student has sufficient consciousness about individual and public health, environmental protection and work safety issues. | X | |||||
| 9 | The student acts in accordance with laws, regulations, legislations and professional ethics related to individual duties, rights and responsibilities. | X | |||||
Assessment Methods
| Contribution Level | Absolute Evaluation | |
| Rate of Midterm Exam to Success | 40 | |
| Rate of Final Exam to Success | 60 | |
| Total | 100 | |
| ECTS / Workload Table | ||||||
| Activities | Number of | Duration(Hour) | Total Workload(Hour) | |||
| Course Hours | 14 | 2 | 28 | |||
| Guided Problem Solving | 7 | 2 | 14 | |||
| Resolution of Homework Problems and Submission as a Report | 7 | 1 | 7 | |||
| Term Project | 1 | 15 | 15 | |||
| Presentation of Project / Seminar | 0 | 0 | 0 | |||
| Quiz | 7 | 1 | 7 | |||
| Midterm Exam | 1 | 17 | 17 | |||
| General Exam | 1 | 27 | 27 | |||
| Performance Task, Maintenance Plan | 1 | 20 | 20 | |||
| Total Workload(Hour) | 135 | |||||
| Dersin AKTS Kredisi = Toplam İş Yükü (Saat)/30*=(135/30) | 5 | |||||
| ECTS of the course: 30 hours of work is counted as 1 ECTS credit. | ||||||
Detail Informations of the Course
Course Description
| Course | Code | Semester | T+P (Hour) | Credit | ECTS |
|---|---|---|---|---|---|
| HEALTH INSURANCE | SKİ2248610 | Spring Semester | 2+0 | 2 | 5 |
| Course Program | Salı 11:00-11:45 Salı 12:00-12:45 |
| Prerequisites Courses | |
| Recommended Elective Courses |
| Language of Course | Turkish |
| Course Level | Short Cycle (Associate's Degree) |
| Course Type | Required |
| Course Coordinator | Assist.Prof. Uygar ÜSTÜN |
| Name of Lecturer(s) | Assist.Prof. Uygar ÜSTÜN |
| Assistant(s) | NONE |
| Aim | To provide the students with the main scope of health insurance and its importance in health management. |
| Course Content | This course contains; Major Finance Models of Health System and Role and Importance of Insurance,Health Insurance Terminology and Classification,Analysis of Private Health Insurance Market by Historical, Technical and Distribution Channels in Turkey,Main Regulatory Frame Work of Private Health Insurance (PHI),Main Regulatory Frame Work of Social Health Insurance (SHI),Organizational Structure, Underwriting and Production Processes of PHI-I,Organizational Structure, Underwriting and Production Processes of PHI-II,Claims and Preauthorization Processes of PHI,Network and Contract Management at PHI,Sustainability for Health Expenditures: Payment Systems and Financial Tools for Chronically Diseases,Complementary and Supplementary Health Insurance (CSHI),Tourism, Health and Insurance,Analyzing Health Data and Strategic Targets-I,Analyzing Health Data and Strategic Targets-II. |
| Dersin Öğrenme Kazanımları | Teaching Methods | Assessment Methods |
| 1. Will be able to interpret health system from macro financial perspective by | 10, 16, 9 | A, E |
| 1.1. Classifying economical systems and major sources | 10, 16, 9 | A, E |
| 1.2. Explaining roles and importance of a variety of financial sources | 10, 16, 9 | A, E |
| 1.3. Defining health expenditure by source and distribution | 10, 16, 9 | A, E |
| 1.4. Explaining importance of sustainable finance system for health expenditures | 10, 16, 9 | A, E |
| 2. Will be able to explain insurance and related subjects by | 10, 16, 9 | A, E |
| 2.1. Clarifying major insurance concepts | 10, 16, 9 | A, E |
| 2.2. Differentiating social and private insurance | 10, 16, 9 | A, E |
| 2.3. Expressing main work frame of insurance system | 10, 16, 9 | A, E |
| 3. Will be able to discuss social and private health insurance by | 10, 16, 9 | A, E |
| 3.1. Explaining information on social health insurance system | 10, 16, 9 | A, E |
| 3.2. Identifying organizational and functional structure of private insurers and their relationships with healthcare providers | 10, 16, 9 | A, E |
| 3.3. Refining regulation, organization and functional structure of general health insurance | 10, 16, 9 | A, E |
| Teaching Methods: | 10: Discussion Method, 16: Question - Answer Technique, 9: Lecture Method |
| Assessment Methods: | A: Traditional Written Exam, E: Homework |
Course Outline
| Order | Subjects | Preliminary Work |
|---|---|---|
| 1 | Major Finance Models of Health System and Role and Importance of Insurance | A literature review about the subject |
| 2 | Health Insurance Terminology and Classification | A literature review about the subject |
| 3 | Analysis of Private Health Insurance Market by Historical, Technical and Distribution Channels in Turkey | A literature review about the subject |
| 4 | Main Regulatory Frame Work of Private Health Insurance (PHI) | A literature review about the subject |
| 5 | Main Regulatory Frame Work of Social Health Insurance (SHI) | A literature review about the subject |
| 6 | Organizational Structure, Underwriting and Production Processes of PHI-I | A literature review about the subject |
| 7 | Organizational Structure, Underwriting and Production Processes of PHI-II | A literature review about the subject |
| 8 | Claims and Preauthorization Processes of PHI | A literature review about the subject |
| 9 | Network and Contract Management at PHI | A literature review about the subject |
| 10 | Sustainability for Health Expenditures: Payment Systems and Financial Tools for Chronically Diseases | A literature review about the subject |
| 11 | Complementary and Supplementary Health Insurance (CSHI) | A literature review about the subject |
| 12 | Tourism, Health and Insurance | A literature review about the subject |
| 13 | Analyzing Health Data and Strategic Targets-I | A literature review about the subject |
| 14 | Analyzing Health Data and Strategic Targets-II | A literature review about the subject |
| Resources |
| Türkiye'de Sağlık Sigortası, Siyasal Kitabevi, Emine Orhaner, 2018 |
Course Contribution to Program Qualifications
| Course Contribution to Program Qualifications | |||||||
| No | Program Qualification | Contribution Level | |||||
| 1 | 2 | 3 | 4 | 5 | |||
| 1 | Knows how to access current basic, theoretical and applied scientific knowledge in the field of Health Institutions Management by using information technologies and resources; evaluates the accuracy, reliability and validity of this information. | X | |||||
| 2 | Recognizes the subdivisions of the health system organization and the employees working in these departments, has knowledge about the duties, authorities and responsibilities of the employees, plans, organizes and directs the performance of health service providers. | ||||||
| 3 | Uses basic theoretical and practical knowledge, basic computer programs and related technologies related to the field of Health Institutions Management. | ||||||
| 4 | To be able to carry out a given task independently using the basic knowledge in the field of Health Institutions Management. | ||||||
| 5 | Evaluates the basic knowledge and skills acquired in the field of Health Institutions Management with a critical approach; identifies learning needs and directs learning. | X | |||||
| 6 | Uses information and communication technologies together with computer software at least at the basic level of European Computer Driving License required by the field of Health Institutions Management. | ||||||
| 7 | The student complies with and contributes to quality management and processes. | X | |||||
| 8 | The student has sufficient consciousness about individual and public health, environmental protection and work safety issues. | X | |||||
| 9 | The student acts in accordance with laws, regulations, legislations and professional ethics related to individual duties, rights and responsibilities. | X | |||||
Assessment Methods
| Contribution Level | Absolute Evaluation | |
| Rate of Midterm Exam to Success | 40 | |
| Rate of Final Exam to Success | 60 | |
| Total | 100 | |