The course fits into the overall program curriculum pursuing some of the defined general learning goals. In particular, the course contributes to the development of the following capabilities:

• Understand context, functions, processes in a business and industrial environment and the impact of those factors on business performance

• Identify trends, technologies and key methodologies in a specific domain (specialization streams)

• Interact in a professional, responsible, effective and constructive way in a working environment, also motivating group members

Students will be able to:

• Understand the main components and economic issues of the organization, financing and delivery of health care systems within which performance must be measured
• Describe the difference between measures of inputs, outputs and outcomes and the purposes of each type of measure
• Use performance measures and appraise their results for improving outcomes of health care systems and accountability of health care providers
• Critically analyze a performance measurement system within specific policy and managerial decision-making contexts, understanding the key success factors and the challenges to its successful use

SETTING THE CONTEXT OF PERFORMANCE MEASUREMENT: THE ECONOMICS OF HEALTH CARE SYSTEMS

Organization, financing and delivery of health care services

• The architecture of health care systems
• Resources allocation and organization of health care systems
• International comparison of health care systems

Demand for health and health care

• The Grossman model
• The agency relationship between patients and physicians

Supply of health care

• The hospital industry

ISSUES, METHODOLOGIES AND USE OF PERFORMANCE MEASUREMENT IN HEALTH CARE

A framework for the measurement of performance in health care

The different dimensions of performance

• Health
• Clinical quality and appropriateness
• Financial protection and equity
• Efficiency

Performance measurement for policy and managerial decisions

• Targets
• Public reporting
• Incentives and professional improvement
• Cross country comparisons

In order to provide students with the necessary skills to operationalize the theoretical concepts related to performance measurement, special attention will be devoted to the data to be used, to their sources and to their appropriate treatment for the application of the different methodologies

No pre-requisites

Students attending the course will be assessed according to the following assignments:

Problems Sets                       20%

Forum                                  20%

Essay #1 (individual)             20%

Essay #2 (group)                  40%

Problems sets

There will be 2 problem sets focused on the topics related to the economic analysis of the health care systems aimed at testing students’ understanding of the tools and techniques of economic analysis as applied to health care. They will be assigned during the lectures at appropriate times (students will be provided with the dates of these assignments at the beginning of the course) and will build on the material discussed in class and in the readings.

Forum

Discussion forums aim at a critical appraisal by students of the course material as well as at eliciting a contribution with their own thoughts, insights and questions. They are also an opportunity for students to exchange and share ideas. The teacher, to generate initial discussion and to focus on particular aspect of the course contents, will open forums on the Beep platform. Forums will be opened all along the course and they will cover all its different areas. Posting in the forum needs to be limited to no more than 200 words. Evaluation of participation will be based on understanding of the subject matter, thoughtfulness, conciseness, innovation, critical thinking and peer engagement. Posting regularly is also an element for evaluation even if frequent posts without substance will not be rewarded. Students should aim at posting at least once for each forum. Areas of discussion and dates of forums will be communicated at the beginning of the course.

Essay #1

Each student will be assigned a performance measure from the ones studied during lectures and will provide a one-page evaluation of this measure in terms of understandability, transparency, relevance, comparability and strength. Students will work on this essay after completion of the lectures on the different dimensions of performance. The date the essay is due to be handed in will be communicated at the beginning of the course.

Essay #2

It represents the final assignment of the course and it is meant to apply knowledge developed throughout the course as well as to critically appraise its contents. Self-selected groups of students (2-3 people) will make a proposal of a work aimed at comparing and contrasting performance measures for two different “units” (countries, regions, providers) so as to assess their relative strengths and weaknesses, taking into account the nature of the context within which they operate. The essay will also contain a briefing note for the representatives of the “units”, explaining their situation and the main implications for the organization. Essays will be presented and discussed in class seminars (20 minutes presentation and 10 minutes discussion). Dates for proposal, delivery and discussion of essays will be provided at the beginning of the course.

All other students will be assessed by a written examination (a problem set plus open ended questions) during the ordinary exams sessions.