PUB HLTH 7081OL - Health Economics

Online - Semester 2 - 2018

Health economics is the study of how scarce healthcare resources are allocated among competing interventions and among groups in society. This course introduces basic concepts and practical issues faced by decision makers at all levels in the health system in allocating scarce resources so that the choices they make maximise health benefits to the population. This course has four main learning modules each comprising a set of lectures and problem-solving practicals: (1) An introduction to key concepts of health economics (e.g. opportunity costs), the demand for and supply of health services, fundamentals of markets and the price mechanism with a focus on the healthcare market; (2) An introduction to economic evaluation in healthcare, with an emphasis on identifying, measuring, valuing and analysing health outcomes and costs. (3) This module focuses on presentation and interpretation of the results of economic evaluation and the use of economic evaluation to inform funding decisions (4) An overview of the organisation of health care (provision and funding). The organisation and finance of the Australian health system will be specifically analysed and compared internationally.

  • General Course Information
    Course Details
    Course Code PUB HLTH 7081OL
    Course Health Economics
    Coordinating Unit Public Health
    Term Semester 2
    Level Postgraduate Coursework
    Location/s Online
    Units 3
    Contact Online
    Available for Study Abroad and Exchange N
    Incompatible PUB HLTH 7081
    Course Description Health economics is the study of how scarce healthcare resources are allocated among competing interventions and among groups in society. This course introduces basic concepts and practical issues faced by decision makers at all levels in the health system in allocating scarce resources so that the choices they make maximise health benefits to the population. This course has four main learning modules each comprising a set of lectures and problem-solving practicals: (1) An introduction to key concepts of health economics (e.g. opportunity costs), the demand for and supply of health services, fundamentals of markets and the price mechanism with a focus on the healthcare market; (2) An introduction to economic evaluation in healthcare, with an emphasis on identifying, measuring, valuing and analysing health outcomes and costs. (3) This module focuses on presentation and interpretation of the results of economic evaluation and the use of economic evaluation to inform funding decisions (4) An overview of the organisation of health care (provision and funding). The organisation and finance of the Australian health system will be specifically analysed and compared internationally.
    Course Staff

    Course Coordinator: Dr Hossein Afzali

    Course Coordinator: Dr Hossein Afzali
    Phone: +61 8313 0615
    Email: hossein.hajialiafzali@adelaide.edu.au
    Location: Level 9, Adelaide Health and Medical Sciences building

    Student & Program Support Services Hub
    Email: askhealthsc@adelaide.edu.au
    Phone: +61 8313 0273


    Course Timetable

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

  • 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)
    Deep discipline knowledge
    • informed and infused by cutting edge research, scaffolded throughout their program of studies
    • acquired from personal interaction with research active educators, from year 1
    • accredited or validated against national or international standards (for relevant programs)
    2-5
    Critical thinking and problem solving
    • steeped in research methods and rigor
    • based on empirical evidence and the scientific approach to knowledge development
    • demonstrated through appropriate and relevant assessment
    1, 2, 5-7
    Teamwork and communication skills
    • developed from, with, and via the SGDE
    • honed through assessment and practice throughout the program of studies
    • encouraged and valued in all aspects of learning
    1-6
    Career and leadership readiness
    • technology savvy
    • professional and, where relevant, fully accredited
    • forward thinking and well informed
    • tested and validated by work based experiences
    1-7
    Intercultural and ethical competency
    • adept at operating in other cultures
    • comfortable with different nationalities and social contexts
    • Able to determine and contribute to desirable social outcomes
    • demonstrated by study abroad or with an understanding of indigenous knowledges
    6-7
    Self-awareness and emotional intelligence
    • a capacity for self-reflection and a willingness to engage in self-appraisal
    • open to objective and constructive feedback from supervisors and peers
    • able to negotiate difficult social situations, defuse conflict and engage positively in purposeful debate
    1-7
  • Learning Resources
    Required Resources
    No single general textbook covers the whole subject matter of this course. Much of the reading resources for 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. There will be assigned readings to complement the lectures and practicals.  These readings will be available on the University Intranet (MyUni: https://myuni.adelaide.edu.au/) to which all enrolled students will have access.
    Recommended Resources
    The following books and peer-reviewed journal articles are avaibale through the Barr Smith Library

    Module 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.
    •   Glied S, Smith P. The Oxford handbook of health economics. 1st ed. New York: Oxford University Press; 2011. Feldstein PJ. Health Care Economics. 7th ed. New York: Delmar Publishers; 2012.

    Module 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.
    ·    Simoens S. Health Economic Assessment: A Methodological Primer, Int. J. Environ. Res. Public Health 2009; 6:2950-2966.
    ·    Petrou S, et al. Economic evaluation alongside randomised controlled trials: Design, conduct, analysis, and reporting, BMJ 2011; 342:d1548.
    ·    Gafni A, et al. Incremental cost-effectiveness ratios (ICERs): the silence of the lambda. Soc Sci Med. 2006; 62: 2091-100.

    Module 3: Equity in health care
    ·    Culyer A. Equity – some theory and its policy implications. J Med Ethics 2001; 27: 275-83.
    ·    Cookson R, et al. Principles of justice in health care rationing. J Med Ethics 2000; 26: 323-9.
    ·    Culyer A. The bogus conflict between efficiency and vertical equity. Health Econ 2006; 15: 1155-8.
    ·    Norheim O, et al. Guidance on priority setting in health care (GPS-Health): The inclusion of equity criteria not captured by cost-effectiveness analysis. Cost Eff Resour Alloc 2014; 12:18.  

    Module 4:  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.
    ·     Eichler HG, et al. Use of cost-effectiveness analysis in health-care resource allocation decision-making: How are  cost-effectiveness thresholds expected to emerge? Value Health 2004; 7: 518-528.

    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
    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, lectures, practicals, and more  information on learning support services available for students.
  • Learning & Teaching Activities
    Learning & Teaching Modes
    This course gives a high priority to interaction between the student and the academic staff, and amongst students. There are a  number of teaching and learning modes in this course. The online course lectures provide information on key concepts in  health economics and economic evaluation of health care interventions. Lectures are intended to cover material in the study guides and  readings and will be supported by problem-solving practicals and quizzes. These practicals and questions are designed to develop and clarify topics covered in the readings and lectures. Students will  be able to post questions and answers to a discussion board. Monitored by the course coordinator, students will be encouraged to answer each other’s questions. Assignments provide an  opportunity to undertake exploratory and in-depth analysis of some key concepts introduced in the course.
    Workload

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

    The information below is provided as a guide to assist students in engaging appropriately with the course requirements. This course  has four main learning modules each comprising a set of six to eight lectures (average length 30 minutes), most of which include  quizzes to consolidate learning of the presented content.  There will also be 14 problem-solving practical sessions. Students will also 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. As a general  rule, in any university course, students will need to allow a minimum of three independent study hours for every hour undertaken in  formal class work contact. This time is needed for such activities as reading around topics, preparation for class activities, and work on assignments.
    Learning Activities Summary
    Topic Lecture
    Fundamental issues in health economics What is health economics; Choice under  Scarcity; Opportunity  cost; Demand and supply analysis; (case study: Medical workforce); Markets and efficiency
    Economic Evaluation Introduction to economic evaluation; Cost measurement; Outcome measurement; Multi-attribute utility instruments (MAUIs);  Choice of MAUIs;
    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
    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
    The organisation of health care;  Assignment review Organisation of health care; health insurance,  health care purchasing; Providing  support with respect to the final assignment.
    Specific Course Requirements
    N/A
    Small Group Discovery Experience
    N/A
  • 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 course objective(s) being addressed
    Short answer questions for economic evaluation Summative 20% 1, 3,4
    Critical review of an economic
    evaluation
    Summative 30% 4,5
    Discussion paper Summative 50% 1,2,6,7
    Assessment Related Requirements
    None.
    Assessment Detail
    All assignments will be posted on MyUni at least 2 weeks prior to the date of submission.
            
    (1) Short answer questions  for economic evaluation (word limit: 250 words for each question) (20%) 
    This assessment task requires short answers to five questions relating to key concepts in health economics, and the identification and measurement of health care resources and health outcomes for economic evaluation . These questions will assess students’  understanding and skills to identify relevant health outcomes and resources in economic evaluation and to interpret key concepts in health economics.  

     (2) Critical review of an economic evaluation (Word limit: 1,500 words) (30%)
    In this assessment students are expected to apply key steps they have learnt during this course to critically review a published economic evaluation. This assignment will assess student’s understanding and skills to critically appraise economic evaluations and to  appropriately interpret their findings.
     
    (3) Discussion paper (Word limit: 2,000 words)(50%)
    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. This assignment will assess students’ understanding and skills to apply analytic thinking to examine evidence on an important health  economic topic.
    Submission
    Extensions
    All extensions for assignments must be requested, at the latest, by the last working day before the due date of submission.   Extensions will generally be granted only on medical or genuine compassionate grounds.  Supporting documentation must be  provided at the time a student requests an extension.  Without documentation, extensions will not be granted.  Late requests for extension will neither be accepted nor acknowledged.

    Only the Course Co-ordinator(s) may grant extensions.

    Supporting documentation will be required when requesting an extension. Examples of documents that are acceptable include: a  medical certificate that specifies dates of incapacity, a police report (in the case of lost computers, car & household theft etc.), a  letter from a Student Counsellor, Education and Welfare Officer (EWO) or Disability Liaison Officer that provides an assessment of  compassionate circumstances, or a letter from an independent external counsellor or appropriate professional able to verify the  student’s situation.  The length of any extension granted will take into account the period and severity of any incapacity or impact  on the student.  Extensions of more than 10 days will not be granted except in exceptional circumstances.

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

    All assignments, including those handed in late, will be assessed on their merits.  In the case of late assignments where no  extension has been granted, 5 percentage points of the total marks possible per day will be deducted.  If an assignment that 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, the mark will be reduced by 20% (5% per day for 4 days) to 45%, and so on.

    The School of Public Health reserves the right to refuse to accept an assignment that is more than 7 days late.

    Assignments submitted after the due date may not be graded in time to be returned on the listed return dates.

    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 processed in time to meet usual University deadlines.

    Resubmission
    If a student is dissatisfied with an assessment grade they should follow the Student Grievance Resolution Process  <https://www.adelaide.edu.au/student/grievance/process/>.  Students who are not satisfied with a particular assessment result should raise their concerns with Course Co-ordinator(s) in the first instance.  This must be done within 10 business days of the  date of notification of the result.  Resubmission of any assignment is subject to the agreement of the Course Co-ordinator(s) and  will only be permitted for the most compelling of reasons.
    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.