Introducing new short course for 2023: Economics of Health Care
5 September 2022
EBHC programmes Teaching
In this blog, Course Tutor and Senior Researcher in Health Economics, Dr Padraig Dixon, shares some of the key topics taught on the new short course 'Economics of Health Care', and highlights their relevance pertaining real-world health care challenges, opportunities, and decision-making.
'Should health systems be funded from taxation, charges collected directly from users, or some combination of both? How should we decide on a fair price for drugs and other medical interventions? How do we know which healthcare policies are likely to be successful?' These are just some of the questions explored on the new 'Economics of Health Care' course, 13-17 March 2023, led by Senior Researcher in Health Economics, Dr Padraig Dixon and Senior Research Fellow in Health Economics Dr Catia Nicodemo, as part of the Postgraduate Programme in Evidence-Based Health Care. The course will be relevant to all health care professionals seeking an introduction into the financing of healthcare, economic evaluation of healthcare technologies, and the evaluation of healthcare policies.
Explore key debates in real-world healthcare
All topics covered on this intensive short course are central to all manner of prominent debates in healthcare. A recent example is the proposal to introduce new charges on users of the National Health Service (NHS), which is currently free to all users in England at the point of use, (with some exceptions such as in relation to prescription charges), and funded from general taxation. Professor Stephen Smith, Chair of the Board of Directors at East Kent Hospitals University NHS Foundation Trust, suggested in the summer of 2022 that the NHS could collect means-tested fees directly from patients based on things like the number of days they stay in hospital.
These types of charges remain extremely contentious and at present there seems little prospect for their introduction despite significant pressures on the healthcare system. However, these charges are a routine part of healthcare in many other countries, and attract little controversy. The first part of our new course will therefore explore the advantages and disadvantages of different types of health system financing with respect to wider health, economic and social objectives.
LEARN TO UNDERTAKE AND INTERPRET ECONOMIC EVALUATIONS
In any health system, whatever the manner of its financing, there will be a finite amount of money available to fund healthcare. This course teaches you to answer questions that guide how health systems undertake economic evaluations of different type of intervention such as new drugs, new surgical techniques, and new ways of providing healthcare services, such as, How should this money be spent? Should it target certain types of treatment? Or certain types of patient? Or should it be spent to maximize the health of everyone using the system? .
UNDERSTANDING HOW HEALTHCARE SPENDING INFLUENCES POPULATION HEALTH
The central consideration that guides (or should guide) these debates is that of opportunity cost, which captures the notion that healthcare resources have alternative uses or opportunities available to them. For example, given a fixed healthcare budget, spending money on a newly available drug will take money away from existing uses of that same money. Throughout the course, we will explore the circumstances under which this might or might not be desirable, and will examine how health economists analyse and interpret data on healthcare costs, mortality and quality of life to assess how different types of spending might contribute to or even subtract from overall population health.
HOW CAN WE BEST ANTICIPATE AND EVALUATE THE LONG-TERM IMPACTS OF HEALTHCARE POLICIES
The final part of the course will encourage students to review how healthcare policies can be evaluated when it may not be possible to run a randomized controlled trial. Healthcare policies are sometimes introduced before an evaluation has taken place, or it the results of a policy may take a considerable amount of time to determine. For example, the UK Government’s “Soft Drinks Industry Levy”, enacted in 2018, increased the tax payable on soft drinks containing sugar which made these drinks more expensive. This higher price reduced consumption of these drinks and encouraged a shift from manufacturers to reduce sugar in some of their products. Both of these changes are likely to have some health impact on consumers of these drinks, many of which are likely to be long-term in nature. For example, some of the most serious consequences of childhood obesity may not be apparent until middle or old-age, and the health impacts of this tax on reducing consumption by children will not manifest themselves for a considerable period of time.
We will introduce students to the different ways these and other types of healthcare policies can be assessed using a variety of quantitative techniques and evaluative methods, such as, natural and quasi-experiments, difference-in-difference methods, regression discontinuity designs, and instrumental variables.
The structure of this course combines lectures, practical demonstrations, discussions and guest speakers. Successful completion of the course will support engagement with health economists and policy advisors when working with them as advisors, colleagues or research collaborators.