Health Economics - JEM101
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The course features a series of lectures on health economics issues. Lectures are complemented by seminars.
The course provides students with a framework to understand principles of health economics, but also to understand health systems (their funding, pooling of funds, financing, purchasing, and provision of health care, and regulation of health systems). Topics regarding performance, effectiveness, and quality of health systems are also discussed. Learning goals of the course are for students to: 1/ understand health economic principles, market failures and theories associated with them 2/ understand functioning of health systems in developed countries, their fundamentals and recent developments 3/ understand measurements of health status, health system performance and efficiency 4/ understand efficiency measurements of healthcare providers 5/ use economic theory to explain motivation and behaviour of individual stakeholders 6/ use health economic theory and empirical findings to discuss up-to-date issues of health systems in developed countries 7/ assess proposed health policy and/or health systems changes using health economic theory and findings 8/ get an overview of empirical modelling in healthcare – most frequently used methods to assess health economics reforms and phenomena 9/ be aware of available datasets collecting health data and strategies to select topics for health economics research 10/ be able to design own health economics research Populations of developed countries are ageing, chronic diseases prevalence is on rise, all resulting in rising demand for health care. Technological progress brings innovations that transform into new, usually more efficient and safer, but also costlier, ways of treating diseases. These effects put pressure on public budgets which are used to finance health care and pose question of health systems’ financial sustainability without compromising access to needed health care for all citizens. At the same time, there are number of examples of poor quality and ineffectiveness of resource utilization in public health systems. Thus, the importance of understanding health economics is increasing. Poslední úprava: Votápková Jana, PhDr. Mgr., Ph.D. (24.01.2024)
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Requirements: It is highly recommended to attend all lectures and seminars Composition of the final grade: 1. 40 % final exam Final exam will be health on May 24 at 9.30 at the IES (room TBA)
2. 20 % Presentation of a paper - group work + presentation of own ideas for a paper Students will be divided into groups (no. of groups will be announced after final enrolment in SIS) Deadline for division into groups March 1 - Team presenting on March 1 will be awarded 5 extra activity points for early-birds. Instructions for class presentations: Each group will be assigned a paper for presentation (available in Moodle). Presentation must include slides. Length max 20 minutes The group presentation will be followed by individual presentations of group members, where each member will present one´s on ideas for a research proposal supported by other available research, dataset, variables (10 mins) A class discussion will conclude. Papers to choose from include: - Papers listed as seminar reading below to support the lecture and induce class discussion, available for sign-up in Moodle Also own ideas are welcomed, however their presentation is subject to prior approval of the teacher
3. 15 % Participation in group discussions in class Active participation in class includes discussions of the topics, supportive reading and discussion during group presentations - Includes also homework for April 26 (see below)
4. 5% HW for April 26 – list of research ideas from empirical papers discussed in lectures or seminars until April 26. Think through the ideas we have come up so far prior to the lecture and come up with your own questions regardless of whether data is available or not. We will provide feedback to you together in class. Deadline April 25. Submission in Moodle.
5. 20 % research proposal for a health economics paper A research proposal should be 2-3 pages long, including abstract, short literature review, methods used, dataset analyzed. Written in LaTeX. It can by inspired by a paper presented by your group or presentation of any other paper in class by other groups or guest lectures Deadline May 17, 2024. Submission in Moodle. Late submission will be awarded 0 points. You are welcome to discuss the preliminary version with the instructor.
Grading scale: !! Three criteria – presentation, research proposal, exam - must be passed, i.e. it is necessary to score at least 51% from each of these core 3 criterion!! Poslední úprava: Votápková Jana, PhDr. Mgr., Ph.D. (24.01.2024)
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Core readings: 1. Bhattacharya, J., Hyde T., Tu, P. (2014) Health Economics Supportive reading for seminars: - Interesting papers that should capture your attention - Available under weeks in syllabus, available for student presentation to fulfill one of the requirements Poslední úprava: Votápková Jana, PhDr. Mgr., Ph.D. (24.01.2024)
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Structure of the course ALL LECTURES START AT 9:30 am Central European Time! SEMINARS will follow right after the lecture, with a short break. Final exam will take a written form on May 24, 2024 at 9.30 at the IES A class will be set up on Moodle for class and assignment administration. Password will be shared in class (Health Economics 2023/2024).
Lecture dates + seminar dates - syllabus: 1. Feb. 23 – Introduction. Health economics in the context of public economics. Data. Health as special goods. Actors in health. Why is healthcare market different?
Reading: Olsen (2017), Principles in health economics and health policy. Ch 3 What makes the market for healthcare different, pp. 47-60 Bhattacharya (2014), Health Economics. Ch1 Why health economics? pp. 1-5 Seminar: No seminar reading this week.
2. March 1 – Grossman model – demand for health Reading: Bhattacharya (2014), Health Economics. Ch 2. Demand for health, pp. 8-27 Bhattacharya (2014), Health Economics. Ch 3 Demand for health: The Grossman model, pp 28-50
Seminar reading: · Santos, J. V., & Cylus, J. (2024). The value of healthy ageing: Estimating the economic value of health using time use data. Social Science & Medicine, 340, 116451 · Votapkova, J., & Zilova, P. (2016). The abolition of user charges and the demand for ambulatory visits: evidence from the Czech Republic. Health economics review, 6(1), 1-11 · Hartwig, J., & Sturm, J. E. (2018). Testing the Grossman model of medical spending determinants with macroeconomic panel data. The European Journal of Health Economics, 19, 1067-1086
3. March 8 – Inequality in health. Health insurance. Moral hazard. Adverse selection. Uncertainty Reading Bhattacharya (2014), Health Economics. Ch 4 Socioeconomic disparities in health, pp 51-75 Bhattacharya (2014), Health Economics. Ch 7 Demand for insurance, pp. 126 – 140 Olsen (2017), Principles in health economics and health policy. Ch 7 Uncertainty and health insurance, pp. 107-117 Seminar reading: · Pascual, M., Cantarero, D., & Lanza, P. (2018). Health polarization and inequalities across Europe: an empirical approach. The European Journal of Health Economics, 19, 1039-1051 · Adams-Prassl, A., Boneva, T., Golin, M., Rauh C. (2022) The impact of the coronavirus lockdown on mental health: evidence from the United States, Economic Policy 37 (109), pp 139-155
4. March 15 – Adverse selection and moral hazard
Reading: Bhattacharya (2014), Health Economics. Ch 8 Adverse selection: Akerlof´s market for lemons, pp 141 – 161 Bhattacharya (2014), Health Economics. Ch 11 Moral hazard, pp 203 – 227 Seminar reading: · Van Winssen, K. P. M., Van Kleef, R. C., & Van de Ven, W. P. M. M. (2018). Can premium differentiation counteract adverse selection in the Dutch supplementary health insurance? A simulation study. The European journal of health economics, 19, 757-768 · Johansson, N, de New, S., C., Kunz, J, S., Petrie, D., Svensson, M. (2023) Reductions in out-of-pocket prices and forward looking moral hazard in health care demand, Journal of Health Economics, 87.
5. March 22 – Health care providers (physicians). Health labour market. Provision of HC in the EU.
Bhattacharya (2014), Health Economics. Ch. 5 The labour markets for physicians, pp. 78-99 Olsen (2017), Principles in health economics and health policy. Ch 10 Primary care, pp. 140-152
Seminar reading: · Dzampe, A. K., & Takahashi, S. (2022). Competition and physician-induced demand in a healthcare market with regulated price: evidence from Ghana. International Journal of Health Economics and Management, 22(3), 295-313 · Muller, T., Schmid, C., Gerfin, M. (2023) Rents for pills: Financial incentives and physician behavior. Journal of Health Economics 87
March 29 – Easter holiday
6. April 5 – Health care providers (hospitals). Competition of providers. Efficiency measurements. Bhattacharya (2014), Health Economics. Ch. 6 The hospital industry, pp. 100 - 123 Olsen (2017) Principles in health economics and health policy. Ch 2 Economics and Efficiency, pp. 17 - 45 Jacobs, R., Smith, P.C., Street, A. (2006) Efficiency in health care. Analytical techniques and health policy, Ch 3 Stochastic frontier analysis of cross-sectional data pp 44-68 Jacobs, R., Smith, P.C., Street, A. (2006) Efficiency in health care. Analytical techniques and health policy, Ch 5 Data envelopment analysis pp. 91-128 Mastromarco, C., Stastna, L., Votapkova, J. (2019) Efficiency of hospitals in the Czech Republic: Conditional efficiency approach. Journal of Productivity Analysis, 51, pp. 73-89 Seminar reading: · Lábaj, M., Silanič, P., Weiss, C., & Yontcheva, B. (2018). Market structure and competition in the healthcare industry. The European Journal of Health Economics, 19(8), 1087-1110 · Hiscock, R, Pearce, J., Blakely, T., Witten, K. (2008) Is neighborhood access to health care provision associated with individual-level utilization and satisfaction?, Health Service Research, 43:6
7. April 12 - Advanced Healthcare Management Institute: Comparison of reimbursement methods.
Reading: Olsen (2017), Principles in health economics and health policy. Ch 11 Secondary care: reimbursing hospitals, pp. 153-159 McPake et. al (2020), Health Economics: An international Perspective. Ch 16 Health systems around the world, pp. 173 - 184
Seminar: Group discussion. Students will be apriori divided into groups (in Moodle) Reading will be provided in Moodle too.
8. April 19 – Governments and health policy. Public vs. private provision of health. System evaluations.
McPake et. al (2020), Health Economics: An international Perspective. Ch 13 Health systems, pp. 135 – 143 McPake et. al (2020), Health Economics: An international Perspective. Ch. 14 Tax and social health insurance mechanisms, pp 144 – 159 McPake et. al (2020), Health Economics: An international Perspective. Ch 15 Private financing mechanisms, pp. 160-172 Olsen (2017), Principles in health economics and health policy. Ch 8 Compulsory insurance, pp. 120-126 Olsen (2017), Principles in health economics and health policy. Ch 9 Patient payment, pp. 127 - 135 Olsen (2017), Principles in health economics and health policy. Ch 13 Economic evaluation and priority setting, pp 169 – 181 Olsen (2017), Principles in health economics and health policy. Ch 15 Equity issues: going beyond CBA and ICER, pp. 207 – 2Z| Zweifel et al. (2009) Health Economics. Ch 13 The political economy of healthcare, pp. 429 - 439 Seminar reading: · Cylus, J., Williams, G., Carrino, L., Roubal, T., & Barber, S. (2022). Population ageing and health financing: A method for forecasting two sides of the same coin. Health policy, 126(12), 1226-1232 · Abu-Zaineh, M., Awawda, S. & Ventelou, B. (2020): Who bears the burden of universal coverage. Health Policy and Planning, 35, 867-877
9. April 26 – Empirical research in health economics + selected methods - overview and datasets available for health research.
Reading: McPake et al. (2020), Health Economics: An international Perspective. Ch 23 Introductory applied health econometrics, pp. 271 – 289
Seminar reading: - Seminar papers read until now - HW: prepare questions that may stir further research and we will discuss them in the seminar (activity points).
10. May 3 - Health insurance cont. - The Rothschild-Stiglitz model. Reading: Bhattacharya (2014), Health Economics. Ch 9 Adverse selection: The Rothschild-Stiglitz model, pp. 162 – 183 Seminar reading: · Martin Boyer, M., & Peter, R. (2020). Insurance fraud in a rothschild–stiglitz world. Journal of Risk and Insurance, 87(1), 117-142 · Jiang, Y., & Ni, W. (2019). Risk selection into supplemental private health insurance in China. Health Economics Review, 9(1), 1-11
11. May 10 – Presentation of a guest lecturer (Andrea Menclová)
Topic: You´ll never walk alone – The effect of walkability on Pregnancy Behaviors and Outcomes Andrea´s profile: https://profiles.canterbury.ac.nz/Andrea-Menclova/about
12. May 17 – Health technology assessment. Pharmaceutical Market Reading: Bhattacharya (2014), Health Economics. Ch. 14 Health technology assessment, pp. 278 – 299 Bhattacharya (2014), Health Economics. Ch. 12 Pharmaceuticals and the Economics of Innovation Zweifel et al. (2009) Health Economics. Ch 12. Market for pharmaceuticals, pp, 400-428.
Seminar: Revision for the exam Assignment: Deadline for Paper proposal Poslední úprava: Votápková Jana, PhDr. Mgr., Ph.D. (09.02.2024)
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