How complex assignements are you thinking of? The simplest thing is to present to students a case study of the use of medical procedure or RCT or Clinical effectiveness analysis (CEA) and to ask them to identify all cost categories, that the procedure implies (for public payer, patient), including the indirect ones. The andvantage of this task is that it could be for ¨101¨mode (student do not have know anything about HE whatsoever). A good idea (much complex though) is to use problem-based learning technique, where you divide students for task groups and based on the CEA you ask them to perform simple economic evaluation (cost minimization, cost-effectiveness). One lesson after another going through the process of preparing evaluation. Other ideas is to ask them for identifying the most important limitations of presented economic evaluation or to ask to what extent they agree with the results of economic evaluations (with justification). Hope I helped.

My colleague and I have developed a strategic role play "Noricum" which has been published here:

Buchner F, Frick U (2011) „Noricum“ oder: wie bringt man die Dynamik eines Gesundheitssystems in den Hörsaal? in: Berendt B, Szczyrba B, Voss H-P, Wildt J, (Hg.) Neues Handbuch Hochschullehre. 2. Ausgabe 2006ff, 48. Ergänzungslieferung; Kapitel C 2.17, Berlin/Stuttgart: Josef Raabe

It is on negotiating a remuneration system in a fictitious state of Noricum and forces students to read selected chapters / articles on incentive structures, tax-based vs. premium-based health insurance and so forth before developing a strategy for their own group (hospitals, government, public and/or private health insurance, GPs in private practice etc.). During a period of e-mail based and/or face-to-face negotiations, the financial and legislative framework of Noricum's healthcare system is established. Teachers during the last period give feedback on both the result and the interaction processes. If you are able to read German, you might get an idea to transfer it to another language and to modify the starting scenario according to your didactical needs.

Hi,

I agree with Krzysztof Lach. You can ask for a critical appraisal to a health economics paper (for instance a cost-effectiveness one) asking to review it using a checklist (the one by Drummond or others).

In a short health economics course where I teach, we use to split the task into groups and ask them to design a economic evaluation of a new program. They have to think in the perspective, the cost (direct health and non health and indirect cost), the disccount rate, teh effect, etc... Once this has been done, they have to present the design to the other groups that comment on the proposal. Students like this kind of approaches.

Ana

Hi, as already stated, it depends on the students (and on the time). We for example teach medicine students 4 courses health economics lasting 90 minutes per course. Overall, about half of the time we are speeking and the other half is for assignments. So, the assignments can not be very complex...

To give you some details:

First course: "International comparison of health care systems" is about the basics of market-based, social insurance-based and state-run health care system. As assginment, we split the students in three groups, each receives a short text with basic information (financing, health care spendings, coverage, access, and so on, but also some "outputs" like newborn mortality; "OECD health data" is great for such data) of an example country for one of the three approaches and the student discuss these things.

Second course: "Principles of financing statutory health insurance and privat health insurance in Germany." Here the assignment is to caculate the premium people have to pay for each type of insurance, based on a very simple population-example (indentical for both insurance types) including incomes and health care costs for three age classes and two risk groups. This is a very nice assignment, because the students can see how different the money is reallocated under each of the insurance types.

Third course: "DRG" For the assignment, we give the students the German DRG-catalogue and some text based examples of hospital cases. the students then look for the DRG-code and calculate the reimbursment for the hospital.

Fourth course: Health care costs and cost-effectiveness analyses. For the cost part we give the students a statistic about health care costs by diseases and gender as well as age in Germany, and they discuss why the most expansive ones are the most expansive ones, or why costs for women are higher than for men and so on. For the C-E part we give the students an abstract of an C-E analysis and they shall calculate the ICER, quite simple. In future, we may split this course into two. Then my idea for the C-E assignement is as follows: The students get parts from a really really bad made C-E analysis (it IS really really bad...) with the mission to make it better.

I hope, I could give you some inspiration, Alex

Hello. Good to see a question similar to one I have.

I am teaching Health Management to MPH students in India. For Health Economics course, a faculty from London School has given a novel exercise. The students in groups were asked to go a government healthcare organisation and asked to find what are the costs incurred by the patients. They will have to find all costs including some tips paid. Then they have to break them in to direct and indirect costs.

What I would like to add to that would be a more emphasis on the opportunity cost such as wage loss and so on.

In addition, my other idea for the students would be to explore different health insurance schemes including public schemes(if there is one). Then explain how it works.

For my management course where the evaluation comes, I generally discuss with papers and solved Cost Effectiveness or CB papers in different parts of the world. They will have to read as a group and they will have present them. There are papers with different models in addition to CEA or CBA.

Later, I give some figures to calculate CEA. Now, for the coming batch, I am thinking of introducing the DEA.

For CBA, I teach them the concept of Benefit Cost Ratio. Then also explain the discounting concept. Then move on to NPV and IRR terms. The formula for NPV then the rate at which the NPV is 0 is IRR. Later take them to Excel and give some solved problem values and demonstrate them the NPV and IRR. In addition, there are online sheets which solves the NPV and IRR problems by just feeding the values and the rate. They are fun for them to try hands on .

I think there are two ways to address the issue: one involves the methods of economic evaluation and interpretation of the data, the other which I think is more important is a broad discussion on the importance of the drug industry and medical materials on clinical decisions . The latter is more practical and also ethical and philosophical. But I believe we have an obligation to make that discussion with students as part of the training process.