HEALTH ECONOMICS

This course belongs to the free-choice teaching activities of the Master progamme in "Economics, Finance and Sustainability" curriculum "Economics - QEM". Health economics is a growing field of studies in economics concerned with the use of economic concepts to analyze issues related to health and healthcare. The goal of this course is to discuss selected topics within this field which are of utmost relevance for the management of healthcare organizations. The course will cover both micro- and macroeconomic issues. At the macro level, attention will be paid first to explaining cross country variation in health spending, with a particular emphasis on the role of productivity and the role of technology and innovation. At the micro level, the focus will be on the market for hospital services, which still represent about half of the healthcare spending in many countries. On the demand side, the course will analyze the choice of patients and the importance of information and networks. On the supply side, the course will focus on organizational design: at the firm level, discussing the role of not-for-profit hospitals as compared to physicians’ cooperative, for-profit clinics, public hospitals; at the market level, analyzing the quasi-market model and the role of incentives provided by different payment systems; at the sub-national level, providing a discussion of the implications of federalism and decentralization. Market outcomes will be finally considered in the light of inefficiency in spending and inappropriateness in the services provided. The discussion for all the topics will couple theoretical arguments with the analysis of real cases useful for the management of healthcare organizations.

After the course the student:

Will have knowledge of the determinants of healthcare spending and their role in explaining the observed evolution of public and private expenditure.

Will have knowledge of the economic arguments relevant for the analysis of the demand and the supply of hospital services.

Will be able to apply the knowledge acquired during the course for critically discussing real world cases related to patients’ choice, the organization of hospitals, the organization of the market for hospital services, the decentralization of healthcare regulation to sub-national governments.

Will be able to apply the knowledge acquired during the course to evaluate the efficiency and the inappropriateness of healthcare provision at different levels of aggregation.

Will be able to correctly interpret the outputs of empirical analyses and to discuss the use of appropriate statistical tools.

Will be able to use economic language and concepts in their analysis and reports.

basic microeconomics (consumer and producer theory, market equilibrium, average and marginal costs)
basic public economics (public intervention, public goods, and externalities, regulation)

Understanding healthcare spending

The economic approach to the analysis of health and healthcare

– Inequalities in healthy life years across countries

The determinants of healthcare spending

– Observing the dynamics of expenditure

– The role of innovation and technology

The demand side of the market for hospital care

The traditional approaches

– The Grossman model: health shocks and the demand for care

Information and networks

– Availability of information and patients’ networks

– The quality of care

The supply side of the market for hospital care

The hospital as a firm

– Not-for-profit providers

– Incomplete contracts and a theory of the ownership of the firm

– Mixed oligopolies and beyond

The hospital as a key market player

– Incentives in the quasi-market model

– The behavior of different types of providers, the role of competition and of information provided to prospective patients

Decentralization and fiscal federalism

– The regulation of hospitals at the sub-national level

– The differences across sub-national systems

Inefficiency and inappropriateness

How to evaluate outcomes

– Methodologies to assess inefficiency and inappropriateness


Case studies

READING LIST

Each topic is covered by a list of selected references (mostly scientific journal articles) that will be provided by instructors and discussed during the lectures. Additional readings will be taken also from:

B.H. BALTAGI-F. MOSCONE (eds.) (2018), Health Econometrics, Contributions to Economic Analysis, Emerald Publishing.


TEACHING METHOD

Lectures and discussion of case studies.

Written exam with open questions and/or analytical exercises. In case, a discussion of the main results of seminal scientific papers.

written

30 e lode (30 cum laude): Excellent, outstanding performance

30: Very good, full mastery of the subject

29-27: Good, solid knowledge with minor inaccuracies

26-24: Satisfactory, decent understanding with some gaps

23-21: Acceptable, basic knowledge but several uncertainties

20-18: Pass, minimum level to succeed

Below 18: Fail, insufficient performance

Lectures
In-class discussion of relevant papers
Presentation of empirical examples

Accessibility, Disability and Inclusion
Accommodation and support services for students with disabilities and students with specific learning impairments

Ca' Foscari abides by Italian Law (Law 17/1999; Law 170/2010) regarding support services and accommodation available to students with disabilities. This includes students with mobility, visual, hearing and other disabilities (Law 17/1999), and specific learning impairments (Law 170/2010). If you have a disability or impairment that requires accommodations (i.e., alternate testing, readers, note takers or interpreters) please contact the Disability and Accessibility Offices in Student Services: disabilita@unive.it.