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 functioning of health care systems in terms of the organization, financing and delivery of services, as well as the main problems characterizing these systems and how performance measurement can be a useful information tool for policies addressing these problems
• 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, during specific practice classes.

A detailed schedule with the dates and the topics dealt with in the lectures and in the practice classes will be provided before the beginning of the course on the BeeP platform.

No pre-requisites

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

Problems Sets                       25%

Essay #1 (individual)             30%

Essay #2 (group)                  45%

Problems sets

Students are assigned two problem sets focused on the topics related to the economic analysis of the health care systems aimed at testing students’ understanding of the economic analysis of the functioning of health care systems. The first problem is assigned as homework, while the second one is for classwork. They will build on the material discussed in class (during lectures and practice classes) and in the readings.

Essay #1

Each student will be assigned a performance measure, selected from the ones discussed during lectures, and will provide a one-page evaluation of this measure in terms of understandability, transparency, relevance, comparability and strength. It aims at testing the ability of students in describing the main characteristics of a performance measure and its purposes. The topic of the essay will be assigned soon after completion of the lectures on the different performance measures.

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 measuring the performance of the health care system of a country, along different dimensions. Each group’s proposal will be discussed in class. The essay will discuss the results of the performance measurement, the weaknesses and the strengths of the exercise, and it will also contain a briefing note for the “representatives” of the country, explaining their situation and the main implications of the results of the work. Guidelines for the structure of the essay will be provided beforehand. Essays will be presented and discussed in class seminars (20 minutes presentation and 10 minutes discussion), during the last week of the course.

A detailed schedule for the dates of the different assignments will be provided before the beginning of the course on the BeeP platform.

Students who will not attend the course will be assessed by a written examination (one problems-set plus two open-ended questions, chosen in two baskets of three questions) during the ordinary exam sessions. Students will have a time allowance of 120 minutes.