The Role of Health Economics,

Research & planning

Dr. Khalid Said Habbani
 A
? What Influences Health
B Occupational Hazards•
Consumption•
?What Is Health Value Patterns•
Perceived attributes of health• Education•
.Health status index: values of life• Income•
.Utility scaling of health•

E C F
Demand for Health care
Micro- Economic Influence of A+B on health care seeking behavior• Market
Evaluation Barriers to access (Price , Time psychological,•
formal), Agency relation ship: need
Equilibrium
Cost effectiveness & cost benefit• Money price•
analysis of alternative ways of Time price•
improving health (e.g. choices of Waiting list & non•
program, delivery method, price
treatment method, etc) D Rationing system as•
Supply of health care Equilibrating
Cost of production• mechanisms and their
Alternative production• .differential effects
;Techniques ; input•
Substitution; market for inputs (man power,•
equipment, drugs, etc) remuneration methods
H of incentives

Planning ,Budgeting &

monitoring Mechanisms
Evaluation of effectiveness of• G
instruments available for
optimizing the system; including Evaluation at whole system level
the interplay of budgeting , man Equity and allocative efficiency criteria brought to bear on•
E+F; inter- regional & international comparisons of
power allocations, norms; performance
regulation, etc and the intensive
structures they generate
The Directorate general of Health
Finance and Economics
 Health organization and economics department (Heath systems)
 Health and economic development
 Organization and delivery systems
 Health manpower
 Organizational behavior
 Health policy
 National Health Accounts department
 Finance the health sector
 Supply analysis
 Financial management
 Budgeting
 Health economics researches department
 Demand analysis
 Project evaluation
A. Health Systems:
1. Health and economic development
2. Organization and delivery systems
3. Health man power
4. Organizational behavior
5. Health policy
 1- Health and economic
development:
Relevant corpus of Some prior questions Planning questions
economics

•Identification and •What constitute health and •How much should be spend
measurement issues of health health Improvement on health?
and illness/disease •What are the determinants of •How much should be spend
•Basic needs measures health improvement on health services?
•Macroeconomic models of •How does health and health
economic development services affect production
•Determinants of growth and the economy
•Human capital theory
•Investment and
consumption elements of
health expenditure
•Household production
function for health
•Ill health and the productivity
of labor
 2- Organization and delivery
systems:
Relevant corpus of Some prior questions Planning questions
economics

• Welfare theory and •What are the economic •How should health services
market failure: characteristics of health care be organized
1. Rationality and health related activities?
2. Consumer sovereignty •What is the relevance of
3. Income and wealth these characteristics for the
issues pursuit of health through
market and non-market
4. Indivisibilities mechanisms?
5. Externalities •How do different health care
6. Public gods and merit systems handle their
goods organization and distribution
decisions?
3.Health manpower

Relevant corpus of Some prior questions Planning questions

economics

• Labor markets and •What determines the supply •What types of health
demand for and supply and distribution of human manpower should be trained
of health workers. resources? and employed?
• Marginal productivity •How do forms of •How should they be trained
theory. remuneration and other
• Factors influencing determinants of behavior
supply elasticities. affect manpower recruitment,
• Impact of income levels absenteeism, retention and
and financial geographical distribution?
incentives.
• Leisure preferences
• Private practice the
brain drain.
4.Organizational behavior
Relevant corpus of Some prior questions Planning questions
economics

• Managerial and •Who makes the resource •How can managers and
behavior theories of allocation decisions to and health workers encouraged to
government, not-for- within the health sector, and increase their efficiency?
profit, profit and what are their objectives?
voluntary •What is the feasibility of
organizations. reconciling the conflicting
goals, values and interests of
the various groups and
individuals involved in the
health sector?
5.Health policy

Relevant corpus of Some prior questions Planning questions

economics

• Optimum welfare •How best can resources be •Does the operation of the
criteria and the concept matched to the population’s health sector reflect the
of the social welfare needs, mortality and government’s objectives e.g.
function morbidity patterns, demands for equity?
• Inequalities and and utilization?
inequities in health •What impact do different
care: definition and health care systems have
measurement issues. upon eligibility, access, take-
• Effect of up and benefits received by
socioeconomic target groups in the
variables and physical population?
access on utilization •What are the barriers, if any,
patterns to the provision of an
equitable (fair) health
services?
B. National Health Accounts
1. Finance the health sector
2. Supply analysis
3. Financial management
1.Finance the health sector
Relevant corpus of Some prior questions Planning questions
economics

• Social accounting •What are the sources of •How can more resources be
systems and public health care financing? obtained for health?
finance. •What type and quantity of
• Revenue generation resources are being utilized
and tax incidence. to finance the health sector?
• Self-finance, insurance •What do alternative financing
and pre-payment methods achieve both in
mechanisms. terms of yield and of
• Ability and willingness- incidence (burden)?
to-pay concepts.
2- Supply analysis

Relevant corpus of Some prior questions Planning questions

economics

• Production functions •What determines the cost •Are some health facilities
and substitutability behavior of organizations and being run more efficiently
between inputs. health agencies? than others?
• Estimation of short- •How and why will costs vary •Can economies be made in
and long –run cost with changes in the scale, existing services?
curves, average and location or type of medical •What size facilities should be
marginal costs, private and health services (and built?
and social costs. facilities) provided?
• Determinants of •What mix of resources will
hospitals and health produce specific services?
centre cost variations
(case-mix, quality
factors)
• Economies of scale.
 3- Financial management

Relevant corpus of Some prior questions Planning questions

economics

• Budgeting systems and •How is the budget divided, who •How can financial management
accountability (cost control the budget, and how is procedures be improved?
centers, cost units). that control exercised?
• Inventory management. •Can economies be affected in
• Determinants of supplier procurement and distribution of
behavior (local, national resources?
multi-national). •What is an ‘appropriate
• Shadow pricing and technology’?
social opportunity costs.
C. Health economics research:

 Demand analysis
 Project evaluation
 1. Demand analysis
Relevant corpus of Some prior questions Planning questions
economics

• Theories of household, •What determines demand or •Why do consumers prefer

individual and supplier- absence of demand for one health agency rather than
induced behavior: specific health services, and other?
1. Generation and for traditional healers, •How can the utilization
interpretation of herbalists and practitioners? pattern of health services be
demand schedules. • What factors determine the influenced??
2. Determinants of provider response to an
demand , price, individual’s demands for
3. Income and cross- health care, including factors
elasticities. Time costs. such as the availability of
referral facilities?
•How do health payment
systems (e.g. charges, pre-
payment methods) affect the
demand for and utilization of
health services?
2. Project evaluation

Relevant corpus of Some prior questions Planning questions

economics

• Micro economics •Does the service do any •Which health programmes or

evaluation: good or have any discernible services should receive
1. Cost benefit and cost effect on health? For whom? highest priority when
effective analysis. •What are the relative allocating new funds?
• Notions of efficiencies (merits and de-
‘effectiveness’ and the merits) of alternative health
‘margin’ activities?
•What are the distributional
1. Size and incidence
(burden) of costs and consequences of health
benefits. activities (who incurs the
cost, who receive the
benefits?)
Staff, knowledge requirement
(qualifications):
 Economics measurements
 Management of information systems
 Research methodology
 Statistics
 Computer skills and software packages
 Financial management
 Communication skills
Economics measurements
Economic Evaluation
 Cost-minimization analysis
 Cost-effectiveness analysis
 Cost-benefit analysis
 Cost-utility analysis
Economics measurements…
Steps of Economic Evaluation
 Identification of costs and consequences
 Measurement of costs and consequences
 Valuation of costs or of costs and consequences
 Adjusting costs and consequences for differential timing
 Incremental analysis
 Sensitivity analysis
Management information
systems:
 “The combination of human and computer-based resources that results in the
collection, storage, retrieval, communication and use of data for the purpose of
efficient management of operations and for business planning”

 System concepts – structure and elements – objectives and types

 Assessment and revision:

 Organizations – scientific management – structure and information – human relations
school and the contingency approach.
 Management – introduction and function.
 Leadership, organizing and coordinating.
 Planning
 Decision making
 Control in organizations
 Information technology
 Computers

Research methodology:
 Surveys
 Health sector finance and expenditure survey
 Four basic steps
1. Define the health sector
2. Describe the scope and objectives of the survey
3. Collect and tabulate the data
4. Present the results
 Assessments
Research methodology….
 Criteria for assessing financing mechanisms
1. Efficiency
2. Equity
3. Demand /utilization and consumer behavior
4. Supply/provision and provider behavior
5. Displacement effects
6. Wider effects of the health sector
Research methodology….
 Public and quasi-public sources of finance
1. General tax revenues
2. Deficit financing
3. earmarked taxes
4. Social insurance
5. Non-profit schemes
Research methodology….
• Private source of finance
1. Private health insurance
2. For-profit services
3. Employer-financed schemes (e.g. banks…etc)
4. Charity and voluntary contributions
5. Community financing and self-help
6. Direct household expenditure
Statistics:
 Descriptive
1. Quantitative
2. Qualitative

 Analytical

1. Quantitative
2. Qualitative
Computer skills and software
packages:
 Win-word
 Excel
 Data base
 Power point
 Project
 Internet
 SPSS
 SAS
 STAT
Financial management:
Objectives:
 Review, consolidate and build on the financial
reform foundation.
 Assist budget improvement, consultation process
and refining report.
 To create models and case studies for budget
preparation.
 To create awareness of steps required in attaining
viability and retaining creditworthiness.
 To build the States financial capacity.
Communication skills:
 Presentations; lectures, shows, symposiums, seminars,
conferences and workshops.
 Dialogue; diffusion of innovations - Health messages.
 Bargaining; logics and argumentation.
 Debates; justification and documentation.
 Advocacy; political commitments, institutional consensus
and community support.
 Pressure groups; labours’ unions and scientific
associations.
 Media; dissemination of information, advertising and
promotion.