PUB HLTH 7081 - Health Economics

North Terrace Campus - Semester 2 - 2014

This course introduces basic concepts and practical issues faced by decision makers at all levels in the health system in allocating scarce resources between competing programs and between different consumer groups. There are two strands: firstly, a consideration of how better allocations might be identified and measured; secondly, an examination of models of health system organization which are claimed to better achieve economic efficiency and equity of access. There will be an introduction to the techniques of economic appraisal applied to health interventions, with an emphasis on cost-effectiveness and cost-utility analysis. There will also be an introduction to the price mechanism in the market, and its strengths and limitations in the production and consumption of health services. Incentives operating variously under market and non-market mechanisms in the provision of health care will be explored. The organisation and finance of the Australian health system will be analysed and compared internationally.

  • General Course Information
    Course Details
    Course Code PUB HLTH 7081
    Course Health Economics
    Coordinating Unit Public Health
    Term Semester 2
    Level Postgraduate Coursework
    Location/s North Terrace Campus
    Units 3
    Contact Intensive
    Course Description This course introduces basic concepts and practical issues faced by decision makers at all levels in the health system in allocating scarce resources between competing programs and between different consumer groups. There are two strands: firstly, a consideration of how better allocations might be identified and measured; secondly, an examination of models of health system organization which are claimed to better achieve economic efficiency and equity of access. There will be an introduction to the techniques of economic appraisal applied to health interventions, with an emphasis on cost-effectiveness and cost-utility analysis. There will also be an introduction to the price mechanism in the market, and its strengths and limitations in the production and consumption of health services. Incentives operating variously under market and non-market mechanisms in the provision of health care will be explored. The organisation and finance of the Australian health system will be analysed and compared internationally.
    Course Staff

    Course Coordinator: Dr Hossein Afzali

    Course Coordinator

    Name Phone Email Location
    Hossein Afzali +618 8313 0615 hossein.hajialiafzali@adelaide.edu.au Level 7, 178 North Terrace
    Additional Academic Staff

    Name Phone Email Location
    Prof Julie Ratcliffe +61 8 82752858 julie.ratcliffe@flinders.edu.au Repatriation General Hospital
    Prof Jonathan Karnon +61 8 8313 3562 jonathan.karnon@adelaide.edu.au
    Level 7,
    178 North Terrace
    Dr Drew Carter +618 83130620 drew.carter@adelaide.edu.au Level 7, 178 North Terrace
    School Office: School of Population Health
    Name Phone Email Location
    Angela Noble +61 8 83134637 angela.nobel@adelaide.edu.au Level 7, 178 North Terrace


    Course Timetable

    The full timetable of all activities for this course can be accessed from Course Planner.

    The full timetable of all activities for this course can be accessed from the Course Planner (https://access.adelaide.edu.au/courses/search.asp)

    The formal teaching for Health Economics consists of lectures and practicals over five separate days at fortnightly intervals.

    Classes are scheduled on the following days:

    28 July            
    11 August
    25 August
    8 September            
    19 September 

    The scheduled class hours are 9.00am to 4.30pm each day, with an hour for lunch.

    The first session will be held at 9:10am on Monday 28 July in Room 307a, Schulz Building, the University of Adelaide.
  • Learning Outcomes
    Course Learning Outcomes
    Upon successful completion of this course, a student will be able to:

    1 Interpret and appropriately apply the key concepts of economics within the context of the health system
    2 Debate the relative merits of equity considerations in setting priorities for a health system
    3 Understand approaches to identify and value costs and outcomes to include in economic evaluation
    4 Describe major types of economic evaluation and to understand their use in the decision-making process
    5 Recognise and apply key steps in critically reviewing economic evaluations
    6 Understand and describe the main features of the Australian health system- in particular how it differs from other salient national health systems according to how services are delivered and purchased
    7 Write concise reports on health economic issues demonstrating sound knowledge and skills to apply analytic thinking for a scientific debate and/or problem solving.
    University Graduate Attributes

    This course will provide students with an opportunity to develop the Graduate Attribute(s) specified below:

    University Graduate Attribute Course Learning Outcome(s)
    Knowledge and understanding of the content and techniques of a chosen discipline at advanced levels that are internationally recognised. 1-7
    The ability to locate, analyse, evaluate and synthesise information from a wide variety of sources in a planned and timely manner. 2,9
    An ability to apply effective, creative and innovative solutions, both independently and cooperatively, to current and future problems. 7,9
    Skills of a high order in interpersonal understanding, teamwork and communication. 7,8
    A proficiency in the appropriate use of contemporary technologies. 2
    A commitment to continuous learning and the capacity to maintain intellectual curiosity throughout life. 1-9
    A commitment to the highest standards of professional endeavour and the ability to take a leadership role in the community. 1-7
    An awareness of ethical, social and cultural issues within a global context and their importance in the exercise of professional skills and responsibilities. 1-7
  • Learning Resources
    Required Resources
    No single general textbook covers the whole subject matter of this course. Much of the reading resourcesfor this course will be sourced from peer-reviewed journals available electronically through the Barr Smith Library and from official and semi-official reports appearing on the World Wide Web. A few photocopied readings will also be made available.
    Recommended Resources
    Strand 1: Key concepts of health economics
    •    Culyer AJ, Newhouse JP. Handbook of health economics. 1st ed. Burlington: Elsevier Science; 2007.
    •    Culyer AJ. The dictionary of health economics. 2nd ed. Cheltenham, UK: Edward Elgar; 2010.
    •    Heggenhougen K, editor. International Encyclopedia of Public Health. 6 volumes. Elsevier, 2008.

    Strand 2: Economic evaluation
    •    Jefferson T, Demicheli V, Mugford M. Elementary economic evaluation in health care. 2nd ed. London: BMJ Publishing; 2000.  
    •    Drummond M. Sculpher M, Torrance G, et al. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University Press; 2005.
    •    Elliot R, Payne K. Essentials of economic evaluation in healthcare. 1st ed. London: Pharmaceutical Press; 2005.

    Strand 3: Health care provision and Health care financing
    •    Duckett SJ, Willcox S. The Australian Health Care System. 4th ed. South Melbourne: Oxford University Press, 2011.
    •    Willis E, Reynolds L, Keleher H. Understanding the Australian health care system. 2nd ed. NSW: Churchill Livingstone; 2009.

    Further reading
    •    Palmer G, Short S. Health care and public policy: An Australian analysis. 4th ed. Melbourne: Palgrave Macmillan; 2010.
    •    McTaggart D, Findlay C, Parkin M. Microeconomics. 6th ed. Sydney: Pearson; 2010.

    For an introduction to Australia's system of government, see:
    •    Department of Foreign Affairs and Trade. Australia’s system of government. http://www.dfat.gov.au/facts/sys_gov.html    
    •    Australian Bureau of Statistics. Year book Australia 2012. (Cat No 1301.0) Canberra: ABS.See the chapter on Government.http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/1301.0Main+Features152012
    Online Learning
    University of Adelaide Students

    MyUni is the primary entry point to online learning at The University of Adelaide.  Students can connect to MyUni on or off campus from an internet connected computer using a Web browser.  The URL is:  https://myuni.adelaide.edu.au/.

    Additional material for this course is available through MyUni.

    This includes the course timetable, practicals, and more information on learning support services available for students.

    Pdf files of the lecture slides will be made available on MyUni usually on the day following the lecture. This timing gives the lecturer the flexibility to respond to student questions and comment as the session proceeds.


    Flinders University Students

    FLO (Flinders Learning Online) is the equivalent online learning system used at Flinders University. Students can connect to FLO on or off campus from an internet connected computer using a Web browser. The URL is: https://flo.flinders.edu.au  or they can login from the Flinders University’s home page.
  • Learning & Teaching Activities
    Learning & Teaching Modes
    This course gives a high priority to interaction between the participant and the academic staff, and amongst participants.

    The course will be presented as lectures supported by problem-solving practicals. Practical sessions will provide an opportunity to explore issues in greater depth. Practical classes will provide a problem-oriented investigation of some of the key course concepts and information. All students are encouraged to participate actively.

    Students who are experiencing any form of difficulty in achieving the course objectives are cordially invited to discuss this with the course coordinator as early as possible.
    Workload

    The information below is provided as a guide to assist students in engaging appropriately with the course requirements.

    Seven hours of face-to-face teaching has been allocated for each of the 5 semester weeks, comprising a mix of lectures and practical sessions. In between these sessions, students will be expected to consolidate content knowledge via assignments.

    To successfully complete their courses, students will need to allocate an appropriate time commitment to their study. In addition to the formal contact (i.e. lectures and practicals), students will need to allocate non-contact time. Non-contact time will be required for a range of activities which may include, but are not limited to, assessment tasks, reading, researching, note-taking, revision, writing, consultation with staff, and informal discussion with other students. As a guide, a full-time student would expect to spend, on average, a minimum of three independent study hours for every hour undertaken in formal class work contact.


    Learning Activities Summary
    Week Topic Lecture
    1 Fundamental issues in health economics What is health economics; Choice under Scarcity; Opportunity cost; Demand and supply; nd (case study: Medical workforce); Markets and efficiency
    2 Economic evaluation Introduction to economic evaluation; Cost measurement; Outcome measurement;Multi-attribute utility instruments (MAUIs); Choice of MAUIs
    3 Measuring and valuing health outcomes Introduction to Discrete Choice Experiments (DCEs); Designing and testing a DCE; DCE for valuing health; Critical appraisal of economic evaluations
    4 Using  economic evaluation in the decision-making process: Equity and efficiency Using economic evaluation in the decision-making process, sensitivity analysis, Frameworks for economic evaluation, Equity in health care
    5 The organisation of health care: Assignment Review Organisation of health care; health insurance, health care purchasing; Providing support with respect to the final assignment.
    Small Group Discovery Experience
    The practical sessions are undertaken in small groups, with close oversight from the lecturers to support discovery around the application of health economics key concepts and health economic evaluation.
  • Assessment

    The University's policy on Assessment for Coursework Programs is based on the following four principles:

    1. Assessment must encourage and reinforce learning.
    2. Assessment must enable robust and fair judgements about student performance.
    3. Assessment practices must be fair and equitable to students and give them the opportunity to demonstrate what they have learned.
    4. Assessment must maintain academic standards.

    Assessment Summary
    Assessment Task Assessment Type Weighting Learning Outcome(s) being addressed
    (1) A one-pager Summative 10% 1,2
    (2) Short answers for economic evaluation Summative 10% 3,4
    (3) Critical review of an economic evaluation Summative 40% 4,5
    (4) Discussion paper Summative 40% 1,2,6,7
    Assessment Related Requirements
    The University of Adelaide’s policy on Assessment for Coursework Programs is based on the following five principles: 1) assessment must encourage and reinforce learning; 2) assessment must measure achievement of the stated learning objectives; 3) assessment must enable robust and fair judgements about student performance; 4) assessment practices must be fair and equitable to students and give them the opportunity to demonstrate what they have learned; and 5) assessment must maintain academic standards (see: http://www.adelaide.edu.au/policies/700/ )

    Flinders University students’ attention is drawn to the Student Related Policies and Procedures Manual 2011 (http://www.flinders.edu.au/ppmanual/student.html), which outlines the University’s Assessment Policy.  A statement of assessment methods can be found on FLO site for this topic.

    Attendance and Participation
    Attendance at all sessions is required, and is a prerequisite for passing this course. An attendance sheet will be completed each day. The reason for any absence should be made known to the course co-ordinator, who may require remedial work. In practicals it is expected that all students should participate actively in the discussion.
    Assessment Detail
    (1) A one-page paper
    The first assessment task involves a constructively critical review of the main argument(s) in the selected paper. Students are expected to develop their own reasoned argument in their own words within a single page.

    It is recommended that the paper begins by establishing the structure of the argument, with key concepts being more important than details. Next might come a critical analysis of the strengths and weaknesses of this argument, with comments from students where appropriate on the logic, on the use of evidence, and on how the argument may have been shaped by the author(s) own values. Any criticism should be constructive and not mere nitpicking. Finally, students should explore the implications for the health of the public, such as how this paper changes our thinking about the issue and what should we do about its findings in order to improve population health. Students might use the three headings: summary of reviewed paper, critical analysis, and implications, but this is not a requirement. Critical reasoning requires that students deal with arguments and counter-arguments.

    The paper should be confined to one A4 page, single-spaced, and in 12 point pitch. Assignments that are over a page will drop a grade. Standard English rather than brief notes or dot points should be used. The paper should be in the student's own words, with quotation and paraphrasing strictly limited and properly referenced in the Vancouver style. References may be placed on a second page.

    (2) Short Answers for Economic Evaluation
    This assessment task requires short answers to 4 questions relating to the identification and measurement of health care resources and health outcomes for economic evaluation. The answer to each question should be confined to one paragraph (a maximum of 150 words).

    (3) Critical Review of an Economic Evaluation  (Word limit: 1,500 words, excluding references)
    In this assessment students are expected to apply key steps they have learnt to critically review a published economic evaluation. Students will answer a number of questions, which will be discussed during this course.  

    (4) Discussion Paper (Word limit: 1,500 words, excluding references)
    Students are asked to choose one of the two topics focusing on the key concepts presented in this course with an emphasis on efficiency, equity, and the health system. The discussion paper must provide an in-depth analysis. This may include background to the topic and its significance, challenges associated with the issue, and some ideas to improve it within the health system.
    Submission
    Turnitin
    Turnitin is a web-based text-matching software system which can be used to teach students how to properly acknowledge quotations, thereby providing an online plagiarism prevention service for both educators and learners. See http://www.turnitin.com

    Turnitin provides a report on any text matches. All work submitted to Turnitin is checked against three databases:
    •    a copy of the publicly accessible Internet as well as archived copies of the Internet
    •    published works (including ABI/Inform, Periodical Abstracts, Business Dateline, and electronic books)
    •    every student paper ever submitted to Turnitin. Students are required to check each assignment in this course for plagiarism before submitting it for assessment.

    Students will submit an electronic version of their assignment and Turnitin will provide a receipt number for each submission and then generate an originality report. The course coordinator may consult this originality report on Turnitin at his/her absolute discretion.

    Adelaide students
    Information about Turnitin including a training video is available at:http://www.adelaide.edu.au/clpd/plagiarism/students/turnitin/ 

    A Quick Guide to Turnitin for Students is available at:http://www.adelaide.edu.au/clpd/plagiarism/students/downloads/UA_student_TurnitinQuickGuide.pdf

    Flinders students
    Information about Turnitin is available at:http://www.flinders.edu.au/current-students/slc/study-guides/turnitin.cfm


    Statement of Acknowledgement of Original Work

    By submitting any assignment in this course students are agreeing to the following:

    Adelaide Students – I declare that all material in this assessment is my own work except where there is clear acknowledgement and reference to the work of others. I have read the Academic Honesty and Assessment Obligations for Coursework Students Policy athttp://www.adelaide.edu.au/policies/230/

    Flinders Students – I have read the Academic Integrity Policy athttp://www.flinders.edu.au/ppmanual/student/assessment1.html

    All Students – I give permission for my assessment work to be reproduced and submitted to other academic staff for the purposes of assessment and to be copied, submitted and retained in a form suitable for electronic checking of plagiarism.

    Extensions
    •    Must be requested, at the latest, by the last working day before the due date of submission.
    •    Will generally be granted only on medical or genuine compassionate grounds.
    •    Only the course co-ordinator, or a person authorised by him, may grant extensions.
    •    Documentary supporting evidence such as a medical certificate or a police report (in the case of lost computers, car & household theft etc.) will usually be required when requesting an extension.
    •    Documentary evidence will be required to support any claim of sickness.
    •    Students submitting examinable written work who request (and receive) an extension that takes them beyond the examination period are advised that there is no guarantee that their grades will be finalised 'in time for graduation' or 'in time to meet usual University deadlines'.

    Lateness
    Marks will be deducted when assignments for which no extension has been granted are handed in late.

    The procedure is as follows:
    All assignments, including those handed in late, will be assessed on their merits.

    In the case of late assignments, marks will then be deducted from the mark awarded, at the rate of 5 percentage points of the total possible per day. For example, if an assignment which is 2 days late is awarded 65% on its merits, the mark will then be reduced by 10% (5% per day for 2 days) to 55%.  If that same assignment is 4 days late its mark will be reduced by 20% (5% per day for 4 days) to 45% etc.

    The Course Coordinator reserves the right to refuse to accept an assignment that is more than 7 days late.

    Resubmission of Work
    Students may request a remarking of an unrevised piece of work previously submitted provided clear academic grounds can be demonstrated. Resubmission of any assignment after revision is subject to the agreement of the Course Coordinator and will only be allowed for the most compelling of reasons.

    The mark obtained following remarking or resubmission will become the substantive mark whether or not it is higher or lower than the original mark. Where the original paper was assessed as below 50% of the available mark, the maximum marks available for a resubmitted revised version will be 50% of the total for that aspect of the assessment.
    Course Grading

    Grades for your performance in this course will be awarded in accordance with the following scheme:

    M10 (Coursework Mark Scheme)
    Grade Mark Description
    FNS   Fail No Submission
    F 1-49 Fail
    P 50-64 Pass
    C 65-74 Credit
    D 75-84 Distinction
    HD 85-100 High Distinction
    CN   Continuing
    NFE   No Formal Examination
    RP   Result Pending

    Further details of the grades/results can be obtained from Examinations.

    Grade Descriptors are available which provide a general guide to the standard of work that is expected at each grade level. More information at Assessment for Coursework Programs.

    Final results for this course will be made available through Access Adelaide.

  • Student Feedback

    The University places a high priority on approaches to learning and teaching that enhance the student experience. Feedback is sought from students in a variety of ways including on-going engagement with staff, the use of online discussion boards and the use of Student Experience of Learning and Teaching (SELT) surveys as well as GOS surveys and Program reviews.

    SELTs are an important source of information to inform individual teaching practice, decisions about teaching duties, and course and program curriculum design. They enable the University to assess how effectively its learning environments and teaching practices facilitate student engagement and learning outcomes. Under the current SELT Policy (http://www.adelaide.edu.au/policies/101/) course SELTs are mandated and must be conducted at the conclusion of each term/semester/trimester for every course offering. Feedback on issues raised through course SELT surveys is made available to enrolled students through various resources (e.g. MyUni). In addition aggregated course SELT data is available.

  • Student Support
  • Policies & Guidelines

    This section contains links to relevant assessment-related policies and guidelines - all university policies.

    Plagiarism
    Students should apply a constructively critical analysis to any material they use in their assignments. Any assignment submitted for assessment at a university must contain the student’s own analysis in the student’s own words. A limited amount of direct quotation is acceptable, provided that it is enclosed in quotation marks, a reference is supplied and an analysis of its relevance is supplied in their own words. 

    Plagiarism is a form of academic dishonesty that amounts to theft or fraud.  It is the unacknowledged use of the thoughts or writings of another person, as if they are one's own.  This may occur as a result of deliberate misuse of another person's work, or through ignorance or inexperience about the correct way to acknowledge other work.  Plagiarism includes presenting information or paraphrasing ideas from books, articles, etc. or other students' work, without clear identification of the source through proper use of referencing; and quoting directly from a source, without indicating that it is a direct quote. 

    This is considered an extremely serious matter, which may lead to failure of an assignment, or even suspension from University.  We will spend some time in early lectures and tutorials dealing with issues relating to plagiarism.

    Adelaide students – should read and understand The University of Adelaide’s Academic Honesty and Assessment Obligations for Coursework Students Policy, a link to which can be found athttp://www.adelaide.edu.au/policies/230/

    Flinders students – see http://www.flinders.edu.au/ppmanual/student/assessment1.html

    A very helpful resource, which addresses positive ways to write about what we have learned is:McGowan U,  O’Regan K. Avoiding Plagiarism: Achieving Academic Writing. Centre for Learning and Professional Development, The University of Adelaide, 2008.
    http://www.adelaide.edu.au/myuni/onlinelearning/learningmodules/avoidingPlagiarism/player.html

    Adelaide students – should also read the guidelines produced by the Discipline of English and Creative Writing on using quotations, paraphrasing and avoiding plagiarism at http://www.hss.adelaide.edu.au/english/studentinfo/plagiarism/

    Flinders students – see Study and Writing Guides at
    http://www.flinders.edu.au/current-students/slc/study-guides/study-and-writing-guides.cfm
    and assessment policies at 
    http://www.flinders.edu.au/ppmanual/student/assessment2.html

    Students must avoid the temptation to cut and paste large chunks from the literature even if they reference them. This is the academic equivalent of train spotting or stamp collecting, and does not necessarily involve any attempt to understand or to analyse the material selected. To meet the University’s Graduate Attributes (see section 2.2), students must do their own thinking about everything they write. Moreover, any passage that students quote verbatim from another author must be enclosed in quotation marks. It is not sufficient to provide the reference alone. Nor is it appropriate to attempt to get around this by lightly paraphrasing a passage from such an author even if students provide the reference.
  • Fraud Awareness

    Students are reminded that in order to maintain the academic integrity of all programs and courses, the university has a zero-tolerance approach to students offering money or significant value goods or services to any staff member who is involved in their teaching or assessment. Students offering lecturers or tutors or professional staff anything more than a small token of appreciation is totally unacceptable, in any circumstances. Staff members are obliged to report all such incidents to their supervisor/manager, who will refer them for action under the university's student’s disciplinary procedures.

The University of Adelaide is committed to regular reviews of the courses and programs it offers to students. The University of Adelaide therefore reserves the right to discontinue or vary programs and courses without notice. Please read the important information contained in the disclaimer.