Health Workforce Accounts Overview

Sustainable Health Economy: Module Recap

• The aim of a health system is to "improve health and health equity, in ways that are responsive, financially fair, and make the best, or most efficient, use of available resources."
• Sustainable health systems aim to minimize negative impacts on the environment, benefiting current and future generations.
• Limited resources and their allocation are crucial aspects of a health economy.

L1: Health Economy, Historical and Political Influences on Health Care Reform

• Health systems aim to improve health and health equity using available resources efficiently and fairly.
• Sustainable health systems minimize environmental harm over the long term.
• Limited resources need strategic allocation to maximize health outcomes.

L2: Economic Perspective, Perfect Markets, and Market Failure in Health Care

• Resource allocation and opportunity costs are central to economics.
• Efficiency (allocative and productive) and equity in resource allocation influence health care markets.
• Perfect markets theoretically lead to allocative efficiency, but they often fail in practice due to market failures like:
  • Monopoly
  • Information asymmetry
  • Externalities
  • Public goods

L3: Health Care as an Economic Good and Demand for Health Care

• Demand for health is "derived demand" – it depends on underlying health needs.
• Demand elasticities (price and income) affect consumer behavior in health care markets.
• Social determinants of health significantly influence demand.
• Information asymmetry between providers and patients affects pricing and service quality.
• Provider-induced demand occurs when providers influence patients’ demand for health care.

S2: Health Information Systems and S3: Measuring Health Need

• Data availability and quality are critical for informed health policy decisions and optimal resource allocation.
• Decision-makers need comprehensive data to identify health problems, make evidence-based decisions, and wisely allocate resources.

### L4: Public-Private Roles in Health Care

• Market structures (perfect competition, monopolistic competition, oligopoly, monopoly) influence healthcare service provision.
• Economies of scale play a role in determining the cost-effectiveness of public and private healthcare services and models.

L5: Private Sector Involvement in Healthcare Delivery

• Decisions about whether to make or buy services have transaction costs that influence the choice between providing or buying-in services.
• Contracting out of services has the potential to increase efficiency and savings, but quality may be affected.
• An example of this is long-term care in the UK.

L6: Health Care Financing and Health Insurance

• Health financing systems include diverse models: tax-based, compulsory social health insurance, private voluntary insurance, and out-of-pocket payments.
• Most countries use a blend of approaches.
• Uncertainty is a feature of health care, and impacts on insurance models.
• Moral hazard, adverse selection, and cream-skimming are potential challenges in insurance systems.

L7: Mobilising Extra Resources: Donor Aid and Innovative Financing

• Strengthening health system funding can involve reducing debt, mobilizing extra resources, and prioritizing health spending.
• Increasing technical and allocative efficiency is important for optimal resource allocation in health.

L8: Externalities and Public Goods

• Externalities refer to the spillover effects of an economic activity on third parties (positive or negative).
• Positive externalities include vaccination effects (herd immunity), while negative externalities may include pollution and climate change.
• Public goods are non-rivalrous and non-excludable, like knowledge, policy, and herd immunity. This necessitates collective action.

L9: Setting Priorities and Defining Benefit Packages

• Priority setting involves identifying the most important health needs given available resources.
• Decision-making on health needs should involve all relevant stakeholders (e.g., patients, providers, policymakers).
• Cost-consequences evaluation is crucial for allocating resources effectively.
• Essential healthcare packages of interventions include measures to maximize benefits from spending in areas like life-saving interventions, treatments, and vaccinations etc.

L10: Prof. Hensher – Ecological Economics for a Post-Growth World

• Prof. Hensher's perspectives on ecological health economics address the impacts of overconsumption and the limitations of economic growth.
• Overconsumption of healthcare and its environmental impacts are a factor to consider.
• Planetary boundaries and ecological economics concepts are important considerations for healthcare's long term sustainability.

L11: Pharmaceutical Supply Chains and Emergencies

• Pharmaceutical supply chains are complex and vulnerable to external shocks (e.g., natural disasters, social unrest). This impacts the security and availability of essential medicines.
• Regulation of the pharmaceutical sector, including oversight of global supply chains is crucial. Supporting local and regional production of essential medicines is beneficial.

L12: Prof. Pollock – Prioritisation of Medicines and Essential Medicine Lists

• The interplay between trade and public health concerns impacts access to medicines.
• Essential Medicine Lists (EMLs) are used to prioritize medicines according to their importance in patient care, and considering the potential for failure of the market system in healthcare.
• Market failures including irrational prescribing, over-treatment, over-consumption, and under-provision of essential medicines are a factor in creating these lists

L13: Health Workforce

• The supply of health workers is influenced by incentives like remuneration, working conditions, training, and career development.
• Demand for workers relies on policy decisions about licensing, capacity of training institutions etc, and is also influenced by payers.
• Cost-effectiveness and efficiency are core considerations; healthcare professionals vary from primary care to specialist care roles.

L14, L15, L16, L17, etc. Modules

• The following modules delve further into health-related topics such as specific types of health worker shortages, retention methods, and global health economics. They cover complex areas requiring extensive content, and so are handled in a separate section for easier readability in study materials.
• The following content covers the short test and covers the core topic of health economics, with related modules encompassing different aspects of this field, including relevant resources, definitions, and further discussion questions.