Syllabus
Lecturer: Petr Háva, MD, PhD, petr.hava@gmail.com; syllabus, lectures, reading on: http://samba.fsv.cuni.cz/~hava
Time & Place: Summer term Thursday 15:30 - 16:50, Jinonice 3019, office hours: Th 13-15 J3009 or 3007
Session 1. (22.2.2008)
Introduction. The State and Scope of Health Economics. Determinants of health. Utility scaling of health. Demand, supply and utilization. Microeconomic evaluation. Market equilibrium. Planning, budgeting. Evaluation of whole system level.
Background reading
Witter, Ensor An Introduction to health Economics. Wiley, England 1997
Introduction, pp. 1-10
Recommended additional reading
Arrow, K.J. Uncertainty and the welfare economics of medical care.
The American Economic Review 1963, 53(5): 941-973
Fuchs, V. The future of health economics.
Journal of Health Economics 2000, 19: 141-157
Savedoff, W.D. Kenneth Arrow and the birth of health economics.
Bulletin of the World Health Organization 2004, 82(2): 139-140
Culyer,A.J., Newhouse, J.P. Handbook of health economics. Elsevier, Amsterdam 2000.
Introduction.: The state and scope of health economics. (pp.1-8)
Session 2. (28.2.2008)
An overview of the economic concepts of the health sector. Microeconomics and market failure in health. The market economy. A simple economy. Determinants of demand and supply. Equilibrium. Why a free market for health care may not function properly. Incomplete market. Imperfect and asymmetric information. Agency relationship. Supply induced demand.
Background reading
Witter, S., Ensor, T. An Introduction to health Economics. Wiley, England 1997
Chpt. 1. Microeconomics and market failure in health
Bailey Public Economics
Mankiw, N.G. Microeconomic Principles
Mankiw, N.G. Principles of Economics. The Dryden Press-Harcout Brace College Publishers, 1998 (czech translation Zásady ekonomie, Grada Publishing 2000)
Recommended additional reading
McGuir, A., Henderson, J., Mooney, G. The Economics of health Care. An Introducing Text. Routledge, London 1994
Chpt. 7
Chpt. 8 Is there a demand for health care?
Chpt. 9 The utilization of health care.
Chpt. 10 The supply of health care.
Muurinen, J.M. Demand for Health. A Generalized Grossman Model
JHE 1982 1: 5-28
Wagstaff, A. Econometric studies in health economics. A Survey of the british literature.
JHE 1989, 8: 1-51
Session 3. (6.3.2008)
Macroeconomic approaches.
Why macroeconomic approach in health economics? What is the subject of health macroeconomics? Reasons for economic evaluation at the whole health care system level (excessive utilization, incosistent medical practice, inefficient delivery and duplication of services, conflicting pressures ? medical advances and growing expectations, macroeconomic limitations on spending with demand for greater and better care through cost containment policies. Performance measurement and improving health system performance.
Theoretical concepts: Parallels with macroeconomics and national accounts,. performance assessment, quality of care, value of health, economic evaluation of health care, effectiveness, efficiency, responsiveness, equity, variations, action.
Health policies: Government regulations, const containment, priority settings.
Analytical tools: System of health accounts (SHA), performance measurement.
Macroeconomics and Health: Investing in health for economic development, sustainable development.
Background reading
Dunning, A.J. Reconciling macro- and micro-concerns: objectives and priorities in health care. Health Policy studies No 9, OECD, Paris 1996, pp. 59-65
Oxley, H., MacFarlan, M. Health care reform controlling spending and increasing efficiency. Economic department working papers No. 149, OECD, Paris 1994
Weisbrod, B.A. The Health Care Quadrilemma: An Essay on Technological Change, Insurance, Quality of Care, and Cost Containment. Journal of Economic Literature 1991, 29: 523-552
Hurst, J. Performance measurement and improvement in OECD health systems: overview of issues and challenges. In: Measuring Up. Improving health system performance in OECD countries. OECD, Paris 2002
Samuelson, P.A., Nordhaus, W.D. Economics. McGraw-Hill, New York 1992
Recommended additional reading
OECD A System of Health Accounts, OECD, Paris 2000
International comparisons of SHA
OECD working papers on health accounts
Murray, C.J.L., Frenk, J. A framework for assessing the performance of health systems. Bulletin of the World Health Organisation 2000, 78(6):
OECD 2006 Projecting OECD health and long-term care expenditures: What are the main drivers? Economic department working papers No. 477, OECD, Paris 2006
Session 4. (13.3.2008)
Economic evaluation of health care. Framework for evaluating medical care, efficacy/effectivness, technical efficiency. Outcomes measurement. Costs analysis. Allocative efficiency (CEA, CBA, CUA). Quality of health care (Donabedian, Maxwell).
Background reading
Witter, S., Ensor, T. An Introduction to health Economics. Wiley, England 1997
Chapt.3. Economic evaluation of health care, pp. 61-80
Recommended additional reading
Drummond, O´Brien, Stoddart, Torrance Methods for the Economic Evluation of Health Care Programmes. Oxford Medical Publication. Oxford University Press 1997
Chapt. 6. Cost-utility analysis. pp. 139-198 examples
Session 5. (20.3.2008)
Pharmacoeconomics.
The supply and demand of pharmaceuticals, prices, multinational pharmaceutical industry, international comparisons. Governemtn Interventions in the Pahramecutical sector.
Background reading
Schweitzer, S.O. Introduction (pp. 3-18) In: Pharmaceutical Economics, and Policy. Oxford University Press, Oxford 1997 nějaký článek z Health Affairs
Recommended additional reading příklady meziárodní srovnání OECD příklad z ČR
Session 6. (27.2.2008)
Options for health sector funding. National health system, social insurance, private insurance, co-payment, direct payment. Anatomy of health insurance ? problems (moral hazard, agent and principal, ).
Background reading
Witter, S., Ensor, T. An Introduction to health Economics. Wiley, England 1997
Chapt. 2. Options for health sector funding
Recommended additional reading
Session 7. (3.4.2008)
Purchasing health care. Stages in purchasing: assessing needs, cost-effective strategies to meet needs, social values and priorities, health care objectives and priorities, contract specifications, performance monitoring.
Background reading
Witter, S., Ensor, T. An Introduction to health Economics. Wiley, England 1997
Chapt. 4. Purchasing health care, pp. 81-94
Recommended additional reading
Figueras Robinson, Jakubowski Purchasing to improve health systems performance. European Observatory on Health Systems and Policies. Open University Press, England 2005
Chapter 1, Introduction. Pp. 3-10
Chapter 4. Theories of purchasing. Pp. 83-101
Session 8. (10.4.2008)
Contracting. Global budgets, health insurance plans
Background reading
Witter, S., Ensor, T. An Introduction to health Economics. Wiley, England 1997
Chapt. 7. Contracting. Pp. 127-142
Recommended additional reading
Session 9. (17.4.2008)
Methods of payment to medical care providers. Outpatient services: FFS, per capita. Inpatient services: Budgeting, FFS, DRG, mixed approaches
Prospective and retrospective approaches, costing of services, regulated prices.
Background reading
Witter, S., Ensor, T. An Introduction to health Economics. Wiley, England 1997.
Chapt. 5. Methods of payment to medical care providers. Pp. 97-114
Recommended additional reading
Session 10. (24.4.2008)
Provider planning and costing. Organization of Health Care Services, Health care systems (national services, social insurance, private insurance, mix).
Background reading
Witter, S., Ensor, T. An Introduction to health Economics. Wiley, England 1997.
Chapt. 6. Provider planning and costing. Pp. 115-126
Recommended additional reading
Session 11. (1.5.2008)
Option appraisal in health care. How to obtain better value for money. Technology assessment. Capital investment decisions, Public private partnership. (De)centralization, regulation, competition
Background reading
Witter, S., Ensor, T. An Introduction to health Economics. Wiley, England 1997.
Chapt. 8. Option appraisal in health care. pp. 143-154
Recommended additional reading
Session 12. (8.5.2008)
Not-For-Profit Ownership and Hospital Behavior. Production function, models, external and internal factors, productivity
Background reading
Recommended additional reading
Session 13. (15.5.2008)
Health care reforms. International comparisons, OECD and WHO databases, expenditures.
Background reading
Recommended additional reading
Annotation
The purpose of this course is to introduce the student to the theoretical concepts and methods of health economics and demonstrate how these methods can be applied to analyze issues in health policy and management. This course will teach the student to use economic analysis to understand critical issues in health care and health policy.
The student will be able:to identify the flow of resources in health care system, evaluate how health care resources are allocated (decision processes), describe the structure of health insurance system, explain the incentives facing different actors, understand the demand for medical care, and what role providers play in shaping this demand