Title: Economics and Financing for Health Services (former name: Health Economics and Economic Analysis)
Keywords: Leadership
Health systems
Health economics
Health Policy
Financing
Country: Germany
Institution: Germany - Institute of Tropical Medicine and International Health, Berlin
Course coordinator: Peter Campbell
Date start: 2022-01-24
Date end: 2022-02-04
About duration and dates: 2 weeks (face-to-face - or online if necessary) The application deadline is 6 weeks before module starts. There are no pre- or post-course assignments, only optional pre-readings, see section remarks.
Classification: advanced optional
Mode of delivery: Face to face
Course location: Institute of Tropical Medicine and International Health,
Charité – Universitätsmedizin Berlin
Campus Virchow-Klinikum
Augustenburger Platz 1, 13353 Berlin, Germany
ECTS credit points: 3 ECTS credits
SIT: 90 hours SIT
• Contact: 70 hours,
• Self-directed learning: 20 hours
Language: English
Description: Overall Objective:
By the end of the module each student should be able to critically discuss, exchange and share views about health economics and health systems financing
Specific Objectives:
By the end of the module, students should be able to:
• Appraise the meaning and limits of basic economic theory and concepts as applied to health and give relevant examples
• Use economic analysis to evaluate health systems performance in LMIC settings, to inform policy-making, and to support decision-making processes when designing interventions
• Explain the advantages and disadvantages of various types of pooling and out-of-pocket payments
• Compare the pros and cons of alternative health services purchasing mechanisms
• Critically assess the impact of health financing mechanisms on performance of the health care system
Assessment Procedures: 1. Group assignment and presentation (50%)
The class is divided into groups of 4-6 students. Then the course coordinator assigns each group a document that covers an aspect of health systems financing from a particular LMIC. Each group then (1) reads the paper, (2) critically appraises the paper in the light of the teaching during the course together with other relevant country information or background topic materials, and then (3) prepares a presentation. The presentation is made to a “Ministerial” panel composed of relevant government ministry representatives and acted out by the Charité course staff/assessors to explain the main aspects of the document and to propose new or alternative ideas that could further address health system improvement.

2. Individual oral exam (50%)
A short individual oral exam (20 minutes) is part of the assessment procedure. The oral exam is based on a set of questions prepared during the course covering the 2 parts of the content: economic theory/ practice and health systems financing. The objective is to assess individually acquired knowledge. In the presence of a neutral observer from the administration unit the teaching staff conducts the oral exam.

Students need to achieve the pass mark of 60% in both, the group presentation, as well as the individual oral exam. The overall mark is the average of the group presentation (50% contribution to overall grade) and the individual oral exam (50% contribution to overall grade).

In case students fail the group presentation, they will be offered a re-sit in the form of an individual essay. A second re-sit in the form of an individual essay is allowed but may be linked to conditions set by the Committee of Admissions and Degrees, such as re-doing the course in the following year.

In case students fail the first attempt of the oral exam, they will be offered a re-sit. A second re-sit is allowed but may be linked to conditions set by the Committee of Admissions and Degrees, such as re-doing the course in the following year or using a different type of assessment.
Content: Building on the knowledge provided in the Core Course, the module focuses on gaining more in-depth knowledge of economic theory and linking this with the use of finances to impact performance of the health system.
PART 1: Health Economics Theory and Practice
Appraisal of health economics, using historic and current case studies. Topics include:
• The relationship between poverty, wealth and health
• Demand for health care
• Revision of economic concepts and principles
o Case study: Introduction of MDR-TB treatment in one LMIC
• Supply of health care
o Case study: Orphan Drugs and Market Failures
• Setting funding priorities
• Costs and costing
• Economic analysis with focus on application in the real world of:
o Cost-effectiveness analysis
o Cost-utility analysis
o Cost-minimization analysis
o Cost-benefit analysis
o Discounting/ waiving
o Uncertainty
o Weighting
• Assessing health systems performance
o Population health measurements: QALYs/ DALYs/ HALYs
• Health insurance markets and different approaches to health insurance
o How do we want to organize our health systems?

PART 2: Health Systems Financing
Analysis of how those with authority think and make financial decisions to influence the level of health care services as efficiently as possible. Topics include:
• Revenue-raising
• Pooling, or not
o Principles of health insurance (e.g. tax, social, community, voluntary, private insurance)
o Out-of-pocket payments
• Purchasing of health care services, including:
o Paying Health Providers
 Fee-for-service
 Capitation payments
 Salary payments
 Performance-based payments (e.g. contracting health services)
o Paying Hospitals
 Line item budget
 Global budget
 Payment per day
 Payment per case (including Diagnostic-Related Groups: DRGs)
• Case study on managing a Sector Wide Approaches (SWAp) in an LMIC, issues regarding district and hospital financing and management, value of financing achievement of SDGs
Methods: In addition to PowerPoint-type slide presentations, adult learning tools and techniques will be used during the course including discussions, debates, roleplay and audio-visual materials.
Throughout the course students have the opportunity to listen to and question relevant experts from the field and guest speakers from international organizations, such as WHO, UNICEF etc. (depending on availability)
The course emphasises participatory learning. It is based on interactive lectures (37 hrs), case presentations (12 hrs), seminars and supervised/guided group work on health economic publications (17 hrs), as well as self-directed learning (20 hrs). (Exam & feedback 4 hrs)
Prerequisites: Successful completion of the core course.
If not a native speaker: Internationally recognised English proficiency certificate equivalent to a TOEFL test 550 or 213 computer-based or 79/80 internet-based or IELTS band 6.0.
Attendance: Max. number of students: 35
Students have to attend 85% of the face-to-face sessions.
Selection: Diploma in International Public Health (DIPH) candidates, who apply in time, i.e. before the application deadline expires (see above), have priority over MScIH/tropEd students, alumni, and guest students. Otherwise, places are allocated on a “first-come, first-served” basis.
Fees: 825.00 € for tropEd/MScIH students and alumni
1031,25 € for DIPH participants and guest students
Scholarships: None
Major changes since initial accreditation: 2021:
• Change of the title of the module from Health Economics and Economic Analyses (HEEA) to Economic and Financing For health Systems (EFHS) to represent the content of the module more precisely
2019:
• Since 2019 the course coordinator is Dr Peter Campbell.
• The course content remains similar to that taught previously.
2015:
• From 2015 the course coordinator was Dr Paul Marschall.
• The content has been adapted to cover all aspects of health economics, from macro- to microeconomics, from supporting policy decision to informing clinical decision, from collecting resources to allocating them. Particular topics have been added, including Sector Wide Approaches (SWAp), Contracting, Performance Based Financing, Decentralization and Community-Based Health Insurance.
• The course now includes more adult learning techniques, like critical discussions, debates and role plays.
2010:
• Since 2010, an individual oral exam has been added to the assessment procedures to better take individual performance into account.
Student evaluation: Students were pleased with the current course coordinator’s teaching style. Students were also pleased with the opportunities given to them for the exchange of experience and debating on different opinions.
Lessons learned: Addressing a field that is often new to tropEd students, the course should not put too much emphasis on technical matters but rather give the necessary tools to understand and critically review health economic information used in the health sector.
Technical jargon should be avoided and the lectures made accessible to non-economists. A critical understanding of the use (and misuse) of economic information should be favoured.
tropEd accreditation: First accredited in September 2005 (Berlin) valid until September 2010
Re-accredited in December 2011 (Berlin), valid until December 2016
Re-accredited in November 2016 (Amsterdam), valid until November 2021
Re-accreditation in October 2021 (Basel), valid until October 2026.
Remarks: Students should watch the following movie clips prior to the course:
• Health economists make the world a better place | Lieven Annemans | TEDxGhent
https://www.youtube.com/watch?v=pQO3EZS9ICw
• Healthcare: is it a right or a luxury? | Tarik Sammour | TEDxAdelaide
https://www.youtube.com/watch?v=jCVmY1iOJQs
• WHO: The many paths towards universal health coverage
https://www.youtube.com/watch?v=VQ3sHfYzcv8
The following pre-reading is recommended:
• Executive Summary of the World Health Report (2010): health systems financing- the path to universal coverage. Accessible at http://apps.who.int/iris/bitstream/10665/44371/1/9789241564021_eng.pdf
• Hendriks, ME et al. (2014), Step-by-step guideline for disease-specific costing studies in low- and middle-income countries: a mixed methodology, Glob Health Action 7:10; DO: 10.3402/gha.v7.23573
• Mills, A. (2014), Reflections on the development of health economics in low- and middle-income countries, Proc. R. Soc. B 2014 281 20140451; DOI: 10.1098/rspb.2014.0451.
Email Address: mscih-student@charite.de
Date Of Record Creation: 2012-01-09 08:39:48 (W3C-DTF)
Date Of Record Release: 2012-01-09 14:50:39 (W3C-DTF)
Date Record Checked: 2021-11-04 (W3C-DTF)
Date Last Modified: 2021-11-21 19:09:07 (W3C-DTF)