Reflecting on two years of our undergraduate health economics module

For the past two years, Edinburgh Health Economics have offered an options module in Health Economics to undergraduate 3rd and 4th year economics students at Edinburgh (ECNM10082). The module, led by Dr Elizabeth Lemmon with Aileen Neilson as co-lecturer and Alistair Bullen as Tutor, aims to provide students with an introduction to the key concepts, methods and understanding of the application of economics to health and health care.

In this post, we summarise the module and the topics covered. We also offer our own reflections on teaching during the pandemic in an online environment and hear what the students’ had to say about the module too.

Overview of the course and topics

When we first ran the course, we split the content quite equally between traditional health economics topics in the first half (health care demand and financing, economic evaluation etc), then the more health econometrics type topics in the second (health inequalities, mental health etc).  This year, based on student feedback, we rearranged things a bit to incorporate some of the more empirical applications earlier on. This worked really well and we think we found a nice flow between topics.

The module begins by introducing health economics and the economics of health, their importance and some of their unique characteristics. It will introduce students to the theory of demand for health care including the Grossman model and its empirical applications, as well as individual health behaviour and the role of behavioural economics in health. Following this, it considers the financing of health care including health insurance and then explores inequalities in both the distribution and financing of health care, drawing on empirical analyses. The latter part of the module focuses on economic evaluation (EE) and decision-making relating to resource prioritisation within health care. It covers the methods involved in EE and explores its application in mental health and the role it plays in decision making in practice.

Specific topic structure

  • Week 1- Introduction to health economics
  • Week 2- Demand for health care and health
  • Week 3- Empirical evidence from the Grossman model
  • Week 4- Consumer choices about health behaviours
  • Week 5- Health insurance and health care financing
  • Week 6- Health inequalities
  • Week 7- Economic evaluation in health care and public health
  • Week 8- Applications of economic evaluation
  • Week 9- Economics and mental health
  • Week 10- The use of economic evaluation in decision-making

You can also find the full module outline here.

A snippet from our recorded lectures

You will have to press play to understand why the photo of the flowers and bee on the first slide are relevant…

The impact of COVID-19 on teaching

The pandemic meant that we did not get to meet any of our students face to face, as all of the teaching was carried out online. We pre-recorded weekly lectures (split up into 3-4 20min chunks) and uploaded them at the same time each week. The tutorials were held via Blackboard Collaborate. For the tutorials, we asked students to submit short thought pieces before attending and then we split the group into smaller breakout rooms for discussions.

In terms of pre-recording the lectures, we felt this worked really well. It meant that students could work through the material at their own pace and stop and start the lecture at any time. Splitting the lectures up also worked well as it created clear ‘breakpoints’ in the content which may help with students’ revision.

Overall, the tutorials worked well, especially the use of breakout rooms to generate discussion amongst students. We did have some connectivity issues and we found it difficult to encourage the students to put their cameras on. We tried implementing the suggestions from a recent publication by Castelli and Sarvary (2020), but with limited success. Interestingly we also asked all groups ‘Would you have your camera on if everyone else had their camera on?’ and the majority said yes! It seemed we failed to establish a ‘cameras on environment’ from the outset and this is something we will try to change next year (if the tutorials take place in an online setting).

Some of the students also said that they felt Blackboard Collaborate was not the best environment for having cameras on because you can only ever see four people on screen at any one time. Whereas, applications like Zoom allow you to see all participants on screen. One student also suggested saying something like ,”Hey everyone, please can I see everyone who is able to, and comfortable with, turning on their cameras now”, in the very first session, then ask the students to introduce themselves with maybe name, course and where they are from.

Some student feedback (from our 2021 cohort)

“It was my first course on a more specialised economics topic (health), so it really opened up a new world of opportunities for me. Also really enjoyed the interactive tutorials.”

“The open structure of the pre-submission topic allowed to explore topics with regards to different countries and their health care system which was very valuable. The tutorials were well structured and resulted in the most discussion among students that I have experienced so far in online tutorials. Overall, I really enjoyed the course!”

“The course was really interesting and well structured.”

“The different areas of the course covered a lot about Health Economics. The online tutorials helped make them more interesting, although at times they have felt very forced. Tutorial participation points have helped however.”

“The lectures and tutorials were good. I also liked the grade breakdown 30% for essay, 10% tutorial and 60% exam.”

“The tutorials are surprisingly valuable. The attendance and homework grade also creates an incentive to stay on track which is really nice.”

Overall, it appeared that the students were happy with the content of the course and the way it was structured. In terms of the online setting, the consensus was that the online lectures worked very well but they would prefer to move back to in person tutorials.

Next semester (starting January 2022), we will be running the course again with more hands on deck from the Edinburgh Health Economics group! Specifically, Katharina and Giovanni will be joining Elizabeth (whilst Aileen takes a step back to focus on her other teaching commitments) to deliver another year of what will hopefully be a successful undergraduate Health Economics module.

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