HEALTH ECONOMICS
Academic Year 2023/2024 - Teacher: Giacomo PIGNATAROExpected Learning Outcomes
1. Knowledge and understanding: students will know and understand the functioning of healthcare systems, with respect to their organization, financing and delivery of services, as well as the main problems characterizing these systems and the way performance measurement can be a useful information tool for the policies dealing with such problems. Lectures represent the means for the realization of this objective.
2. Applying knowledge and understanding: students will acquire skills for the evaluation of allocative problems characterizing healthcare systems and their components, and will apply knowledge on their functioning as well as the performance measurement tools. Students will be able to evaluate the results of performance measurement in the light of the identification of the most effective policies for improving the outcomes of healthcare systems and the accountability of providers of services. The main tool for the realization of this objective is the preparation of a project work at the end of the course.
3. Making judgments: students will critically assess data, reports and other works on the different aspects of the functioning of healthcare systems and on healthcare policies, identifying the success factors and the challenges facing the systems and the policies. Moments of interaction and active participation of students, during the lectures, with the help of digital tools, will contribute to the realization of this objective.
4. Communication skills: students will gain communication skills and appropriateness in the use of technical language, by means of interaction and active participation activities. The presentation of their project works to the class will also contribute to this objective.
5. Learning skills: the learning skills of students will be improved through an appropriate interaction, the preparation of class presentations, the independent study of parts of the program, which will be presented during lectures along very general lines, and then studied independently by each student.
Course Structure
The course will be structured through lectures; interaction and active participation activities, managed by students, some of them realized with the help of digital tools; practice classes and seminars providing a support for the preparation of the project work. Students will read the teaching material beforehand, especially for preparing class presentations and active participation activities.
Required Prerequisites
Detailed Course Content
A – ORGANIZATION AND FINANCING OF HEALTHCARE SYSTEMS
- The architecture of healthcare systems
- Allocation of resources and organization of healthcare systems
- The Italian National Health Service and a comparison with other systems
B – THE FUNCTIONING OF HEALTHCARE SYSTEMS AND HEALTHCARE POLICIES
- Healthcare needs and healthcare demand
- The Grossman model
- The agency relation between physicians and patients
- The supply of healthcare services
- The models of behavior of hospitals
- Remuneration mechanisms for hospitals
C – THE EVALUATION OF HEALTHCARE POLICIES AND THE MEASUREMENT OF PERFORMANCE
- A framework for measuring performance of healthcare
- The dimensions of healthcare performance
- Health
- Clinical quality and appropriateness
- Financial protection
- Equity
- Efficiency
Textbook Information
- R. Levaggi e S. Capri (2013), Economia Sanitaria, Franco Angeli, chapters 1, 2, 3, 9, 10
- G. Turati (2013), The Italian Servizio Sanitario Nazionale: A renewing tale of lost promises, in J. Costa-Font, S.L. Greer (eds.), Federalism and decentralization in European health and social care, Palgrave MacMillan, p. 47-66
- European Observatory on Health Systems and Policies (2022), Italy. Health System Review 2022, chapter 2 (https://iris.who.int/bitstream/handle/10665/365363/9789289059305-eng.pdf?sequence=1)
- E. Caruso e N. Dirindin (2011), Costi e fabbisogni standard nel settore sanitario: le ambiguit del decreto legislativo n. 68 del 2011, Quaderni del Dipartimento di Economia, Fin anza e Statistica dell'Università di Torino, n. 100, p. 1-26
- G. Arachi e A. Zanardi (2010), Tutto ruota intorno ai fabbisogni standard, Lavoce.info, p. 1-3 (https://www.lavoce.info/archives/26591/tutto-ruota-intorno-ai-fabbisogni-standard/)
- CERGAS Bocconi (2022), Rapporto OASI 2022, chap. 2, 3 (https://cergas.unibocconi.eu/observatories/oasi_/oasi-report-2022)
- I. Papanicolas e P.C. Smith (2013), Health system performance comparison, Euroepean Observatory on Health Systems and Policies, Open University Press, chapters 5, 6, 7, 8, 10 (https://www.euro.who.int/__data/assets/pdf_file/0009/244836/Health-System-Performance-Comparison.pdf)
For those interested in further readings on the topics under A and B, in an international perspective: J.Bhattacharya, T.Hide e P.Tu (2013), Health Economics, Macmillan International Higher Education (especially chapters 2, 3, 5, 6, 7, 16, 17, 18).
Course Planning
Subjects | Text References | |
---|---|---|
1 | Introduction to the course | |
2 | The architecture of an healthcare system | Teaching material |
3 | Taxonomy of healthcare systems | Levaggi Capri, chap. 9 par. 2 |
4 | Allocation of resources and the organization of healthcare systems/1 | Teaching material |
5 | Allocation of resources and the organization of healthcare systems/2 | Teaching material |
6 | The organization of the Italian healthcare system (Guided class discussion – please read the suggested references beforehand) | Levaggi Capri, chap. 10 par. 2 + Turati + European Observatory |
7 | The financing of the Italian NHS/1 | Arachi-Zanardi + Caruso-Dirindin |
8 | The financing of the Italian NHS/2 | Arachi-Zanardi + Caruso-Dirindin |
9 | A summary of healthcare in Italy/1 (Guided class discussion – please read the suggested references beforehand) | Oasi 2022, chap. 2 |
10 | A summary of healthcare in Italy/2 (Guided class discussion – please read the suggested references beforehand) | Oasi 2022, chap. 3 |
11 | Healthcare demand, health and healthcare needs | Levaggi Capri, chap. 1 par. 1, 2, 3 |
12 | Healthcare demand: the Grossman model/1 | Levaggi Capri, chap. 1 par. 4, 5 |
13 | Healthcare demand: the Grossman model/2 | Levaggi Capri, chap. 1 par. 4, 5 |
14 | Healthcare demand: the role of physicians | Levaggi Capri, chap. 2 |
15 | Healthcare demand: the empirical analysis | Teaching material |
16 | External presentation to be defined | References will be provided in due time |
17 | Models of behavior of the providers of healthcare | Levaggi Capri, chap. 3 par. 1, 2, 3 |
18 | Payment of healthcare providers | Levaggi Capri, chap. 9 par. 3, 4, 5 |
19 | External presentation to be defined | References will be provided in due time |
20 | Efficiency/1 | Papanicolas Smith, chap. 10/Teaching material |
21 | Efficiency/2 | Papanicolas Smith, chap. 10/Teaching material |
22 | Seminar on applications of performance measures | Teaching material |
23 | Health: measurement at population level | Papanicolas Smith, chap. 5/Teaching material |
24 | Health: outcome and patient-reported measures | Papanicolas Smith, chap. 6/Teaching material |
25 | Seminar on applications of performance measures | Teaching material |
26 | Clinical quality and appropriateness | Teaching material |
27 | Financial protection | Papanicolas Smith, chap. 8/Teaching material |
28 | Seminar on applications of performance measures | Teaching material |
29 | Equity/1 | Papanicolas Smith, chap. 7/Teaching material |
30 | Equity/2 | Papanicolas Smith, chap. 7/Teaching material |
31 | Seminar on applications of performance measures |
Learning Assessment
Learning Assessment Procedures
Students will be assessed by means of a written test and an oral exam. The written test will consist of 8 open-ended questions. 6 questions are meant to check the students' ability to use and apply their knowledge of the main topics of the course, and they will require a short and concise answer. The other 2 questions will require a longer answer on two different arguments, chosen in a group of three questions each. Students who will achieve at least a score of 18/30 in the written test will be admitted to the oral exam. The written test and the oral exam will deal with all the topics of the course.