Health Economics: An International Perspective is the only textbook to provide a truly international, comparative treatment of health economics. Offering an analysis of health systems across borders, the fourth edition of this key text has been updated and revised to take account of changes in a host of countries.

This edition features an expanded introduction, providing better grounding for many of the examples that come in subsequent chapters and making it easier for non-health care experts to see the links between the theory, the examples and the health care system components. It also boasts a restructured format, dividing the book into two broad sections: the first focuses on ideas and principles, along with evidence on their applications in the health sector, whereas the second focuses on introducing core tools and techniques used in applied health economics research.

Further updates to this edition include:

two new chapters on applied econometrics;

a new chapter on equity, focusing on equity in access to health care, paying particular attention to how access and need for health care are defined and measured in applied research;

a new chapter on emerging issues for health systems that are emanating from a series of global transitions both within (e.g. demographic change, epidemiological change, the global resolution on universal health coverage) and without the health sector (e.g. economic transitions).

Throughout the text, examples and illustrations are taken from a wide range of settings and world regions, providing a unique overview of the performance of different health systems.

Table of Contents

1. Introduction: health economics in international perspective PART 1 Introductory health economics 2. The demand for health and health services 3. Production, health and health care: efficient use of inputs 4. Cost of delivering health services 5. Basic market models 6. Supplier-induced demand and agency 7. Market failure and government PART 2 Further economics of markets and market intervention 8. Contracting 9. Market structures 10. Hospital and health provider behaviour and motivation 11. The economics of regulation 12. Incentives and agency PART 3 The economics of health systems 13. Health systems: a framework for analysis 14. Tax and social health insurance mechanisms 15. Private financing mechanisms 16. Health systems around the world: an introduction to variation and performance 17. The economics of health in an era of global transition PART 4 Tools and techniques for measurement and analysis PART 4a Economic evaluation 18. The theoretical bases of economic evaluation 19. Issues in the measurement of costs 20. Measuring benefits in economic evaluation 21. Practical steps in economic evaluation 22. Economic evaluation as a framework for choice PART 4b Applied econometrics and other tools 23. Introductory applied health econometrics 24. Methods and applications for causal analysis 25. Equity in access to health care: key measurement issues.

Health Economics: An International Perspective is the only textbook to provide a truly international, comparative treatment of health economics. Offering an analysis of health systems across borders, the fourth edition of this key text has been updated and revised to take account of changes in a host of countries. This edition features an expanded introduction, providing better grounding for many of the examples that come in subsequent chapters and making it easier for non-health care experts to see the links between the theory, the examples and the health care system components. It also boasts a restructured format, dividing the book into two broad sections: the first focuses on ideas and principles, along with evidence on their applications in the health sector, whereas the second focuses on introducing core tools and techniques used in applied health economics research. Further updates to this edition include: two new chapters on applied econometrics; a new chapter on equity, focusing on equity in access to health care, paying particular attention to how access and need for health care are defined and measured in applied research; a new chapter on emerging issues for health systems that are emanating from a series of global transitions both within (e.g. demographic change, epidemiological change, the global resolution on universal health coverage) and without the health sector (e.g. economic transitions). Throughout the text, examples and illustrations are taken from a wide range of settings and world regions, providing a unique overview of the performance of different health systems.

The formation of health professionals is critical for the health system to function and to achieve its universal health coverage (UHC) goals, and this is well recognized by the majority of governments that plan to ensure enough training places and aim to regulate in order to ensure quality. But the importance of market forces is often overlooked, resulting in interventions and regulations that often fail to achieve their intended effects. This publication aims to inform the design of health professionals' education policies to better manage health labor market forces toward UHC. It documents what is known about the influence of market forces on the health-professional formation process. The report sought to answer the following questions: What have been the large global and regional trends in the development of health professions? How have these trends affected the career decisions of current and potential health professionals? What is the evidence base on the value and effectiveness of health professional education of different types? How has the market for health professional education evolved, and with what interrelationships with the health labor and health care markets? The contexts of the market for health professional training have been subject to important changes in recent decades, in particular: the growing extent of employment of mid-level cadres of health professionals; changes in technology and the associated growth of high skilled occupations; the increasing interconnectedness of national health systems through globalization, with its implications for international health professional mobility; and the greater complexity of the public-private mix in employment options. There is a need to ensure that market forces align with the intentions of planning and regulation and the needs of UHC goals. This publication provides recommendations to support the design of policies that help to achieve these.

This publication is part of the Bank's multiyear program to enhance its knowledge of HRH policies. The program's ultimate objective is to strengthen knowledge and capacity to collect evidence, analyse, and evaluate the effectiveness of HRH interventions in the context of a country's health system strengthening strategy. It specifically addresses the theoretical and empirical evidence on health labour markets in low- and middle-income countries. Health labour market analysis has much to contribute to resolving globally widespread HRH problems, and their continuing neglect provides some explanation for their persistence. Policy makers in countries promulgating or refining strategies for achieving universal health coverage will find it important to understand how key elements in their health labour market are likely to interact and how these interactions could help - or hinder - progress toward universal health coverage. These interactions are complex and multidimensional, and this publication highlights some areas where forces in the health labour market matter most. The purpose of this publication is to provide an overview of the key issues when attempting to apply economics to the analysis of health workers' labour markets. Though much has been written and planned about health human resources, a major weakness with most of this analysis is that it does not use an economic perspective. The use of an explicit economic framework applied by trained economists moves the focus away from simplistic but costly policy responses such as training more doctors and nurses, toward understanding more carefully the role of incentives, productivity, and the distribution of health workers. The health workforce is but one part of the health system and a focus of analysis on only the health workforce is insufficient to be able to determine the optimal number of health workers. Market forces cannot be relied upon to solve health worker shortages or mal-distribution, due to well recognized market failures in health care. This also has implications for how labour economics and labour market analysis can be applied and used successfully in the health care sector.

New ideas on the role of the state in developing countries have considerable implications for the social sectors, especially health. Certain international organizations have advocated a larger role for private sector health care providers and many developing country governments have adopted this approach. Yet, until now, very little evidence has existed about how shifting the balance between public and private roles might affect equity, and the quality and efficiency of health care. This book presents the results from a coordinated programme of research on the private health care sector including studies carried out by Asian, African and Latin American researchers. The conceptual chapters draw upon both industrialized and developing country literature to describe the intellectual terrain, analyse the key issues and summarize experience to date. This book will help increase understanding of the private sector, as well as illustrating the contentious issues involved in privatization. It will be useful to students and academics involved in international public health courses, and to health policy makers in developing countries.