Objectives

Since the 1960’s, economists have studied the properties of health and health care. Their research has changed the way society promotes and maintains health and organizes the provision of health care. The health sector is an important priority for policy, as emphasised by the Covid-19 pandemic, however, it is very complex due to it being highly regulated, with mixed public and private sector organisations delivering and financing healthcare services and promoting health.

In higher income countries, health related expenditures account for the largest proportion of GDP, with expenditures rising faster than incomes. Hence, the sustainability of the financing and delivery of health care is of major concern with pressures to improve productivity and quality of care. There are important socio-economic inequalities in health, moreover, our understanding of health risks and the behaviours that influence them have grown significantly. Hence, the economic influences and cost-effectiveness of interventions to reduce these risks is an important area of research. In lower income countries, health spending is still insufficient to meet the needs of the population, and although significant progress has been made in improving health outcomes and access to better health care through international initiatives; rapidly changing disease burdens, and the problems of adopting necessary health technologies, imply improved mechanisms to finance and deliver health care are needed.

The main goal of the course is to introduce students to the field of health economics by providing a broad overview of some of the topics and fields of research. Through analysis of real-world cases and specific research papers on issues in high, low and middle-income countries; we will demonstrate the application of economic reasoning based on theoretical concepts and sophisticated empirical applications. A small group research project analysing macro and micro-data offers students experience of practical health economics. The course provides important insights into how economics influences the health of populations, the financing and organisation of health care as well as the cost and quality of health care delivery around the world.

Contents

The course applies microeconomic tools supported by robust empirical evidence and real-world case studies, to the understanding of the economics of health behaviours and the organisation of health care markets. We focus on concepts such as the demand for health and health care, health insurance, competition in health care markets, influence of payment systems on health care provider behaviour, and the economics of the pharmaceutical sector. We will also focus on how the research in health economics has assisted our understanding of policy options in the health care industry as well as illustrating the effects of the Covid-19 pandemic.

An outline of the lecture topics and assignment deadlines covered by term weeks is given below:

Lectures

Week 1 Lecture 1. Introduction to health economics

Week 2 Lecture 2 . Economic determinants of health

Week 3 Lecture 3. Education and health

Week 4 Lecture 4. Economics of nutrition and policies (with exemple case study)

Week 6 Lecture 5. Health care Expenditures: Overview and drivers

Week 7 Lecture 6. Health care markets and systems: Physicians, hospitals, regulators, payers

Week 8 Lecture 7. Economics of health insurance I

Week 10 Lecture 8. Economics of health insurance II

Week 11 Lecture 9. Health care financing, incentives and provider payments

Week 13 Lecture 10. Pharmaceutical industry and technological evaluation

Group Assignments

Week 5 Case study 1 group presentation

Week 5 Practical session 1: Health system performance group project

Week 8 Case study 2 group presentation

Week 9 Practical session 2: Health system performance group project

Week 11 Case study 3 group presentation

Week 12 Class Workshop: Health system performance group project

Week 14 Case study 4 group presentation

Week 14 Group 4 group presentation

References

Reading material will consist of published articles from economic journals and specialist health economic field journals. But will also include wider literature from health policy, health services research and medical journals.

Case studies from various sources will be provided with supplementary reading and data to support the analysis of the case.

For the articles and case studies, see the Content and Reading Lists as well as lecture folders to be posted in the Moodle site for the course.

Data and supporting variable data dictionaries as well as information about sources and methods of collection for the group project will be provided.

Pre-requisites

The only prerequisite of the course is to be familiar with microeconomic theory and applications at an intermediate level and applied econometrics and Statistics also at an intermediate level. Some experience of using statistical analysis and data management software such as Stata, R, SPSS and Excel.

Evaluation

First attempt

Exam:

Written 2h00 hours

Documentation:

Not allowed

Calculator:

Not allowed

Evaluation:

The course will be evaluated by the two group work assignments comprising of 1) the group case study presentation and 2) health systems performance group project analysis; course participation during the case study presentations and discussion as well as group project workshops; and a final written exam.

The distribution of grades is as follows:

2 separate group work assignments involving the analysis and presentation of assigned case studies and the health systems performance project: 2 x 20% (40% of final grade).

Class participation during the presentation and discussion of the case studies (at least 3/4) and project workshops (at least 2/3): 20% of final grade (attendance, involvement and contribution to discussion/workshop instructions).

Final written exam: 40% of final grade.

Note that the evaluation modalities may change if required by the COVID situation.

Retake

Exam:

Written 2h00 hours

Documentation:

Not allowed

Calculator:

Not allowed

Evaluation:

A retake evaluation will take the form of a written exam (the grades from the group work, class participation and short essays will NOT count toward the retake evaluation)