UNIVERSITÄT HOHENHEIM INSTITUTE FOR HEALTH CARE & PUBLIC MANAGEMENT Household and Consumer Economics Prof. Dr. Alfonso Sousa-Poza HEALTH ECONOMICS Winter Semester 2011/12 Course Syllabus Course description This course aims at giving students an in depth perspective on key issues in health economics. It is composed of two parts: (i) Lectures and readings on key issues in health economics: The first part of the course will begin with approximately 10 90-minute lectures. These lectures will cover the key issues in health economics, namely the economic valuation of health, the demand for health, the market for physicians, hospital services and optimal remuneration of providers. This part of the course will be based on Peter Zweifel, Friedrich Breyer and Mathias Kifmann Health Economics, 2 Ed., Springer (2009). Supplement readings will also be provided and discussed in the lectures. The lectures will take place on three days (approximately 3 lectures per day) between November 2011 and February 2012. (ii) Lectures and presentations on selected topics in the organization, delivery and financing of healthcare systems: The second part of the course will take place on two consecutive days in January 2012. In these two days, Professor Mohamad Alameddine from the American University of Beirut (Lebanon) will focus on a specific topics related to the organization, delivery and financing of healthcare systems. These topics will bring to focus some of the practical applications of economic theory with examples brought from both developing and developed countries as appropriate. These two days will be a combination of lectures and class presentations by students. Schedule About 10 90-minute lectures will take place throughout the winter semester on three separate days: Day 1: 8 th of November 2011, 10-17 Day 2: 6 th of December 2011, 10-17 Day 3: 10 th of January 2012, 11-17 The 2-day blocked course by Professor Mohamad Alameddine will take place on the 12 th and 13 th of January 2012. The exact location still needs to be determined. 1
Course Requirements Students are expected to actively engage in class discussions by asking questions or providing additional insights into the literature. While students will not be formally graded on classroom participation, we cannot overemphasize the importance of asking questions and probing new idea as an essential mode of learning. Students must have successfully completed an undergraduate microeconomics course. An understanding of basic econometric techniques is also an asset. Requirements to Obtain a Grade for this Course Students taking the course for a grade will complete a written final examination at the end of the semester. The exam will cover the work of the first part of the course, i.e. on the key issues in health economics. Furthermore, students must make a 15-minute presentation and write a short 5-paged paper on one of the topics in the second part of the course. The presentation and short paper will account for 30% of the final grade (the exam comprising 70%). Language The entire course (including presentations and papers by students) will be in English. Lecturers The course will be lectured by Alfonso Sousa-Poza (University of Hohenheim) and Mohamad Alameddine (The American University of Beirut). Alfonso Sousa-Poza holds a Professorship in Consumer and Household Economics at the University of Hohenheim in Stuttgart. He studied computer science at the University of Cape Town, and economics at the University of St. Gallen in Switzerland. From 1996 until 2007 he was employed at the Research Institute for Labour Economics and Labour Law at the University of St. Gallen. His primarily empirical research interests are in the fields of labour, population and health economics. Mohamad Alameddine is currently an assistant professor at the department of Health Management and Policy at the Faculty of Health Sciences, American University of Beirut (AUB). He joined AUB in 2008 coming from the University of Toronto where he worked as a senior research associate and prior to that as Director of International Development at the Faculty of Medicine. Mohamad holds a PhD in Health Management and Policy from the University of Toronto and a Masters of Public health from AUB. His main research interests are focused on studying health human resources labour force dynamics, recruitment and retention practices and the quality of work environments. Mohamad has a number of publications in the field and is regarded as a regional health systems consultant. 2
Course content Part I: Key issues in health economics The following topics will be covered in approximately 10 90-minute lectures and they will be examined at the end of the course: 1. Health economics and the specifics of health What is health economics? Market failure in markets for health goods Justice and rationing 2. Economic valuation of life and health Approaches to the economic valuation of health Cost-utility analysis Cost-benefit analysis 3. Individuals as producers of their health The concept of health production Health as part of human capital The production of health as the modification of a stochastic process Selected empirical studies on the production of health 4. Physicians as suppliers of medical services The hypothesis of supplier-induced demand A model of physician behaviour Empirical examination of the supplier-induced demand hypothesis 5. Paying providers Paying providers to achieve cost control Concerns beyond cost control Implications for the design of payment systems Part II: The Organization Delivery and Financing of Healthcare Systems The following topics will be covered in a 2-day block on the 12 th and 13 th of January 2012: 1. The Anatomy of a Healthcare System Define Health and understand the uniqueness of health care markets. Appreciate the importance of healthcare systems. Understand the systems approach and its applications to health care. Discuss the main components of a healthcare system & the way they relate to each other. Understand the importance of functions and objectives of a health care systems and the way they relate to each other. 2. Introduction to the organization, delivery and financing of healthcare systems Develop an understanding of the various models used for financing health care systems. Discuss the main forms through which health care could be organized. Understand the role of rationing in choosing intervention that are organized and delivered in a health care system. 3
3. Key in health care systems: Health Human Resources Identify global challenges in the number and distribution of HHR Appreciate the relationship between number and types of HHR and health status indicators from a regional perspective Discuss the key cross-cutting' HHR challenges in developing countries Review the stock flow model for labor markets 4. Contemporary issues in healthcare systems Discussion may include but is not limited to: resources production, cost and quality of care, increased competition, increased demands, shortage of human resources, brain drain, equitable distribution, etc. Student evaluation Students will have to work in groups of 2 or 3 to prepare a 15-20 minutes presentation and a 5-page (maximum 1500 words) summary report about the health care system of one of the following countries: Australia Brazil Canada China France India Japan Switzerland United Kingdom USA In both the presentation and the summary report, students would have to offer, in light of their learning experience in this course, a brief overview of the healthcare system and to succinctly answer the following questions: 1- How is healthcare financed? (Where does the money come from and where does it go?) 2- How is healthcare organized and delivered in this country? 3- What are the major advantages of the healthcare systems? 4- What are the points of weakness in this healthcare system? 5- What reform initiatives are being planned? 6- In light of your learning experience in this course, what changes to the healthcare system would you suggest (up to three)? 4
Reference List for Health Systems component Alameddine, M., Baumann, A., Onate, K. and Deber, R. (2010). Career Transitions of Inactive Nurses: A Registration Database Analysis (1993-2006). International journal of nursing studies. 48(2):184-92. Alameddine, M., Laporte, A., Baumann, A. O Brien-Pallas, L., Mildon, B., & Deber, R. (2006). Stickiness and inflow as proxy measures of the relative attractiveness of various subsectors of employment. Social Sciences and Medicine 63(9): 2310-2319. Bravata, D., McDonald, K., Shojania, K., Sundaram, V. and Owens, D. (2005) Challenges in Systematic Reviews: Synthesis of Topics Related to the Delivery, Organization, and Financing of Health Care. Ann Intern Med.142:1056-1065. Deber, R. (2002). Delivering Health Care Services: Public, Not-For-Profit, or Private? Commission on the Future of Health Care in Canada. Discussion Paper number 17. Fried, Bruce & Gaydos, Laura (2002) World Health Systems: Challenges and Perspectives. Health Administration Press, Chicago, Illinois. Organization for Economic Cooperation and Development (2004). Towards High Performing Health Systems (Summary Report). The OECD Health Project. Walt G., Shiffman, J., Schneider, H. et al. (2008) Doing health policy analysis: methodological and conceptual reflections and challenges. Health Policy and Planning. 23:318-327. WHO. (2000) The World Health Report 2000, Health Systems Improving Performance WHO, Geneva. WHO (2006b) The world health report 2006 - working together for health. WHO, Geneva. 5
Programme: Date Topic Literature 26/10, 12:00 Introduction (30 min.) Institutskeller Day 1: 08/11 B12, B11 Day 2: 06/12 S 16 Day 3: 10/01 S 16 Topic 1: Health economics and the specifics of health Topic 2: Economic valuation of life and health cost-utility analysis Topic 3: Economic valuation of life and health cost-benefit analysis Topic 4: Individuals as producers of their health the Grossman model Topic 5: Individuals as producers of their health integrating uncertainty Topic 6: Empirical studies of the production of health Topic 7: Physicians as suppliers of medical services ZBK, Ch. 1 ZBK, Ch. 5 ZBK, Ch. 2.1-2.3 ZBK, Ch. 2.4-2.6 ZBK, Ch. 3.1-3.5 ZBK, Ch. 3.1-3.5 ZBK, Ch. 4 ZBK, Ch. 8 Topic 8: Hospital services and efficiency ZBK, Ch. 9 Topic 9: Paying providers ZBK, Ch. 10 12-13/01 2012; S 16 Selected topics in the organization, delivery and financing of healthcare systems by Professor Mohamad Alameddine (The American University of Beirut, Lebanon) 6
Important dates Please take note of the following dates: 26 th of October 2011, 12 am: Introduction to course 31 st of November 2011: Submission by email of 3 preferences for project topics to Stefanie Heyer (stefanie.heyer@uni-hohenheim.de) 12 th 13 th of January 2012: Part II on Health Care Systems 28 th of February 2012: Submission of 5-page summary by email to Mohamad Alameddine (alameddi@gmail.com), CC Stefanie Heyer (stefanie.heyer@unihohenheim.de) March 2011: Examination on Part I Estimated workload This is a 6 ECTS course, i.e. a workload of at most 180 hours is planned. An overview of the estimated workload looks as follows: PART I PART II Units Hours Total Lectures 9 1,5 14 Preparation / revision for each lecture 9 5 45 Exam preparation 1 40 40 Total 99 Attendance on 2 days 2 8 16 Preparation of presentation 1 40 40 Preparation of paper 1 20 20 Total 76 TOTAL EXPECTED WORKLOAD 175 Contact Administrative issues: Stefanie Heyer, stefanie.heyer@uni-hohenheim.de, Tel: 0711 459 23423 Content issues: Alfonso Sousa-Poza, alfonso.sousa-poza@uni-hohenheim.de, Tel: 0711 459 22584 Mohamad Alameddine, alameddi@gmail.com 7