Courses 2011-12
Review Course in Maths and Statistics
Syllabus
Brief course descriptions
Fall term
Economics of Health and Health Care
This course builds on 'Economics and Financing of Health Care Systems', moving from a description of the main differences in present health care organization systems to the economic analysis of health care relevant for health policy design. The course will deal with the theory of supply and demand in health care, the role of information asymmetries and the organization of the health care and insurance markets. Students will learn how to apply the tools of industrial organization to specific health care markets. In particular, the consequences of the introduction of competition among suppliers (hospitals) and of mergers will be analyzed. Issues of cost containment versus quality will be addressed. Hospital remuneration systems (prospective versus retrospective) will be compared. Several procedures to enforce quality standards will be analyzed. The regulation of the pharmaceutical and other medical inputs industries will be addressed, both for a given structure and to introduce changes in that structure. The ability of firms to price discriminate will be analyzed. Different forms of both direct price regulation (reference pricing, international referencing, drug formularies) and indirect price regulation (copayments, generic substitution, price-cost margin regulation, the regulation of detailing) will be compared. At the end of the course students will be able to assess the impact on efficiency and equity of the major reforms that have been implemented, and to propose possible improvements on these reforms. From a normative perspective, the definition, measurement and comparison of the equity and efficiency performance of health care systems across countries will be analyzed, as well as the analysis of the equity-efficiency trade-offs. These comparisons will include both developed and developing nations. The aim of the course is to improve students' understanding of some of the tools for the economic analysis of health care systems relevant for health policy and to stimulate students' thinking about the development of health system performance indicators.
Winter term
Statistics in Medicine
This course presents and discusses key statistical concepts in the area of medical and health research. It is designed to give insight into statistical thinking and practice as part of the scientific process of knowledge enhancement and discovery in medicine. Topics covered are: The language of statistics: Review of basic statistical terminology, in the medical context. Protocols for medical research: Clinical experimentation vs. epidemiology; cross-sectional vs. longitudinal studies; retrospective vs. prospective studies. Reporting of statistical findings: clinical vs. statistical significance; type I and type II statistical errors; tables and graphs. Inventory of methodology: statistical tests; regression, ANOVA and beyond; distribution-free (nonparametric) alternatives: Scales and indicators: principles of measurement; scale construction. Data reliability: measurement error; missing data; bias and variance; Introduction to multivariate analysis: from exploration to modeling; functional and structural methods; survival analysis. Bayesian reasoning in medicine: role of prior knowledge in statistical conclusions. Meta-analysis: combining evidence from several studies.
Health Microeconometrics
This course provides an overview of the econometric methods for health economics, including qualitative and limited dependent variable, survival analysis, count data models and panel data methods. The emphasis of the course is on the use of individual level data and microeconometric techniques for health data problems. Practically all the course examples and illustrations are based on health economics data and work out with STATA. The objectives of the course are to provide the student with deeper knowledge of microecometric methods with applications, allowing him/her to perform a critical reading of applied papers in health economics and related areas and the development of a short empirical replication using (preferably) health data.
Economic Evaluation of Health: the micro level
We start from the structure of a medical decision, value trees, trade-offs under certainty, preferences and value functions, health outcomes, etc, to then move towards utility theory, with multi-attribute preferences under certainty, eliciting choices (biases and heuristics) and social decisions by aggregation from individuals to group preferences. Contents include: Motivation for the need to perform economic evaluation in the health care sector; definition and techniques of economic evaluation; economic evaluation and public policies; the value of health; health care production; assessing inputs, outputs and outcomes in health care; technology assessment in health care; priority setting and cost analysis; cost analysis of health care services; cost-effectiveness analysis; cost-utility analysis; cost-benefit analysis; structure of a medical decision; trade-offs and decision making; trade-offs and medical decision making; utility theory; decision making under non-expected utility; utility theory and medical decision making; eliciting preferences: biases and heuristics; social decisions: from individuals to groups. Social choice and mechanism design tools will be applied, and non-price allocation mechanisms and prioritization issues will be addressed. An appraisal of other non-economic elements relevant to complement the results of the economic evaluation closes the course.
Biomedicine and Biotechnology in Health Care
Biotechnology and Biomedicine play a relevant role today in the dynamics of the so-called knowledge-based economy. Based on the integration of Biology, Life and Engineering Sciences, the range of applications is wide: human and animal health, food and agriculture, industry, energy and environment. The role of innovation, entrepreneurship and creation of new companies is basic in the evolution of this sector of the new economy. Main topics are: the building blocks of living systems. Cells and enzymes. Enabling technologies. Recombinant DNA. Massive screening. The Biotechnology toolbox: how to bridge knowledge and final requirements. Applications: the pathway from potentialities to products.
Spring term
Global Economic Evaluation of Health
We explore the way and the extent to which health affects global economic outcomes. There are multiple factors constantly interacting, which create difficulties when it comes to estimating the causal effects between improved health status and economic outcomes such as growth and income. This complexity may be captured from different perspectives, both empirical and theoretical, which take in a variety of methodologies that combine microeconomics and macro-dynamic analysis. The main objective here will be to provide results that demonstrate the economic benefits of improved health, and link these results to policy issues. Topics will include the value of health and its measurement (effects of health on output productivity and economic growth, and quality adjusted life years), health as an investment (lifestyle, childhood influences, and educational medical care), the relationship between socioeconomic background and health, the interaction between health, institutions and economic outcomes and resource allocation regarding health.
The Economics of Health Care Organizations
The aim of this course is to provide a wide understanding of key management and organizational issues. Topics include the boundaries of the health care organizations; contracting and hierarchies in health care organizations. cases on integration and contracts; employment in health care organizations, pay for performance; careers in health care organizations; employment systems; decision-making in organizations; decision processes: authority and power; politics and influence; structures and processes in organizations; models of hierarchy and coordination: cases; corporate governance
Ethics and Health
This course aims at taking an analytical and systematic approach to ethical values in medical decisions and policy. A model of rationality which separates and combines economic values with ethical values helps to understand better how decision makers act, and should act, in the face of ethical dilemmas.
Topics in Health Economics and Policy
This course is designed to give an introduction to the professional health economics literature. The topics covered are International comparisons of health expenditure (which includes an introduction to cointegration techniques and their uses in panel data); Individual health behaviour and the Grossman model, (this includes the importance of Instrumental variables in health economics), The re-interpretation of the demand for health insurance (based on demand for access to health care rather than coverage of uncertainty per se), incentive payments in health care (payments of providers with empirical and theoretical examples), government purchasing of health care and the complexities in determining appropriate levels of the quality of health care, the economics of the hospital sector (including empirical specifications which incorporate demand uncertainty), measuring hospital competiton and the impact of health reforms, productivity measurement in health care, and measuring equity in health care through concentration curves.
Topics in Public Health
The efforts of societies to improve health and increase longevity have constituted a major ongoing collective enterprise. The aim of the course is to provide a broad perspective of the determinants of population’s health and to illustrate how social, economic, environment, and health services factors have an influence.
Lectures, readings, and class discussions will cover, among others: the evolution of major causes of disease over time; measurement issues that affect the definition of health and disease; approaches to assess the relative contribution of health services and other factors on population’s health. Issues relating both to currently industrialized countries and developing countries will be discussed.
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