Health economics is an applied field that uses economic theory to study the production, consumption, and distribution of health services, aiming to improve health outcomes efficiently and equitably. It addresses resource scarcity by analyzing healthcare financing, provider behavior, and the cost-effectiveness of interventions, with a focus on enhancing both quality of care and accessibility. Health economics is an applied field of study that examines and finds systems-based solutions to make healthcare more equitable, accessible, and affordable for all. Health economists seek to understand the role that stakeholders (such as healthcare providers, patients, private insurance companies, government agencies, corporations, and public organisations) play in healthcare spending. From a Public Health point of view, health economics is just one of many disciplines that may be used to analyse issues of health and health care, specifically as one of the set of analytical methods labelled Health Services Research. But from an economics point of view, health economics is simply one of many topics to which economic principles and methods can be applied.
Jessica Gronlund is a Professor of Health Economics at the Harvard T.H. Chan School of Public Health, where she focuses on health policy, behavioral economics, and maternal and child health. Her research examines how health systems, policies, and programs influence maternal and newborn health in the U.S. and East Africa with the aim of embedding this evidence into policy design and increasing policy impact. A principal investigator on the Bridges to Primary Care study funded by AHRQ, she is leading efforts to transform postpartum primary care coordination for postpartum chronic and mental health conditions. Her broader research portfolio includes studying prenatal care quality, stillbirth prevention, postpartum health system engagement, and behavioral interventions to enhance health care delivery. Her work has been published widely in top economics and public health journals and has been referenced in major national and international publications. Her research on subsidy policies for insecticide treated nets was deemed by Vox as a top social science paper of the decade. Dr Jessica was a member of the WHO Global Malaria Program's Technical Expert Group on Surveillance, Monitoring and Evaluation and has served on NIH expert review panels related to implementation science and impact evaluation. She has also co-authored the behavioural economics chapter in the textbook Health Behavior: Theory, Research, and Practice. A dedicated educator and mentor, Dr. Jessica has won awards for her teaching and mentorship and previously served as Director of Graduate Studies for the Harvard Health Policy PhD Program. She teaches courses on econometric impact evaluation and maternal and reproductive health policy, equipping students with methodological tools and policy insights. Her research has been supported by agencies such as the National Institutes of Health, the U.S. Agency for International Development, the Agency for Healthcare Research and Quality, and the National Academy of Medicine.
Preface 1. HEALTH CARE AS AN ECONOMIC COMMODITY ..............................1 1.1 Introduction 1.2 Health and health care as commodities 1.3 Basic principles of expected utility theory 1.4 The nature of health care 1.5 Conclusions 2. THE COST-BENEFIT APPROACH IN THEORY ....................................19 2.1 Introduction 2.2 The principles of the cost-benefit approach 2.3 The valuation of human life 2.4 The process of the cost-benefit approach 2.5 Conclusions 3. INTERNATIONAL COMPARISONS OF HEALTH EXPENDITURE....41 3.1 Background and overview 3.2 Why international comparisons? 3.3 Methodological problems 3.4 First-generation studies 3.5 Cross-section multivariate regressions 3.6 Second-generation studies 3.7 Summary and concluding remarks 4. NORMATIVE ECONOMICS OF THE HEALTH SECTOR.....................79 4.1 Introduction 4.2 Efficiency and normative frameworks 4.3 Health care as an economic commodity 4.4 Equity in the health sector 4.5 Evaluation of programs and interventions 4.6 Concluding observations: health economists as policy advisors 5. MEDICAL CARE PRICES AND OUTPUT.............................................132 5.1 Introduction 5.2 The market environment underlying medical care CPIs and PPIs 5.3 Construction of medical care CPIs and PPIs at the BLS 5.4 Related research on medical care price indexes 5.5 A new medical care expenditure price index based on episode treatment costs 5.6 Medical care price indexes in the national income and product accounts 6. THE HUMAN CAPITAL MODEL...........................................................184 6.1 Introduction 6.2 Basic model 6.3 Pure investment model 6.4 Data and results 6.5 Extensions 6.6 Health and schooling 6.7 Conclusions 7. CONSUMER INCENTIVES IN HEALTH CARE...................................228 7.1 Introduction and overview 7.2. Dimensions of consumer incentives in health care 7.3 The amount of delegation of authority to the physician 7.4 Incentives and ex ante moral hazard 7.5 Incentives and static ex post moral hazard 7.6 Dynamic ex post moral hazard 7.7 Concluding remarks 8. PHYSICIAN AGENCY..............................................................................253 8.1 Introduction 8.2 Demand and supply for physician services 8.3 Physician behavior with complete information 8.4 Uncertainty about treatment effects and asymmetric information 8.5 Physician-induced demand 8.6 Other physician objectives 8.7 Conclusion Bibliography...............................................................................................306 Index...........................................................................................................329
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