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Inhalt des Dokuments


Registration now closed for WS 2017/2018

There is only limited capacity for the running semester due to organisational changes in the running semester. The seminar is open for our cooperation partner from Ghana.


Health care systems are complex and usually not well understood. This course provides a structured introduction into how health care systems are organized, financed and regulated. Units will provide a general introduction into the framework and functions of health care systems, into coverage (of persons and benefits), into resource mobilization, pooling and allocation to third-party payers, purchasing and third party payer-provider relationships, regulation of health care providers as well as questions regarding the public-private mix. Well-known types of health care systems ("Bismarck", NHs etc.) will be presented and discussed. Participants should have a prior knowledge of health care and are expected to read and discuss the course material (literature listed below and presentation slides as they are made available during the course).

Semester (WS/SS)
Managing and researching health care systems


Introduction and frameworks

Papanicolas I (2013). International frameworks for health system comparison. In I. Papanicolas & P. C. Smith (Eds.), Health System Performance Comparison. An agenda for policy, information and research, pp. 31-75. Berkshire: Open University Press.

World Health Organization (2000). World Health Report Health systems: improving performance. Geneva: WHO Document Production Services. http://www.who.int/whr/2000/en/

World Health Organization (2007). Everybody’s business: Strengthening health systems to improve health outcomes. WHO’s framework for action. Geneva: WHO Document Production Services. http://www.who.int/healthsystems/strategy/everybodys_business.pdf

Health care financing

Thomson S., Foubister T., Mossialos E. (2009.) Health care financing in the European Union. In S. Thomson, T. Foubister, E. Mossialos (Eds.), Financing health care in the European Union. Challenges and policy responses, pp. 23-26. Copenhagen. http://www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm

Kutzin J. (2008). Health financing policy: a guide for decision-makers. Health financing policy paper. Copenhagen: WHO Regional Office for Europe. http://www.euro.who.int/__data/assets/pdf_file/0004/78871/E91422.pdf

Mills A (2014). Health Care Systems in Low- and Middle- Income Countries. The New England Journal of Medicine 370 (6): 552-557 http://www.nejm.org/doi/full/10.1056/NEJMra1110897#t=article

World Health organization (2010). Health Systems Financing. The path to universal coverage. Geneva: WHO Press. Retrieved from http://www.who.int/whr/2010/10_summary_en.pdf?ua=1.

Busse R. Figueras, J., Robinson R., & Jakubowski E. (2007). Strategic purchasing to improve health system performance: key issues and international trends. HealthCare papers, 8, 62-76. https://www.mig.tu-berlin.de/fileadmin/a38331600/2007.publications/HP_vol8_SpIssue_busse_purchasing.pdf

Mathauer I, Dale E, Meessen B. Strategic purchasing for Universal Health Coverage: key policy issues  and  questions.  A  summary  from  expert  and  practitioners’  discussions  Geneva:  World  Health  Organization; 2017. http://apps.who.int/iris/bitstream/10665/259423/1/9789241513319-eng.pdf

Ellis, R. P. & Miller, M. M. 2009. Provider Payment Methods and Incentives. In: CARRIN, G. (ed.) Health systems policy, finance, and organization. Amsterdam: Elsevier Academic Press:

Kronick R, Casalino LP, Bindman AB (2015): Introduction. Apple Pickers or Federal Judges: Strong versus Weak Incentives in Physician Payment. Health Serv Res. 2015 50(2):2049-56

Mathauer I, Wittenbecher F (2013): Hospital payment systems based on diagnosis-related groups: experiences in low- and middle-income countries. Bulletin of the World Health Organization 2013;91:746-756A. doi: dx.doi.org/10.2471/BLT.12.115931

Quentin, W., D. Scheller-Kreinsen, M. Blumel, A. Geissler and R. Busse (2013). "Hospital payment based on diagnosis-related groups differs in Europe and holds lessons for the United States." Health Aff (Millwood) 32(4): 713-723.


Sidibé M, Campbell J (2015) Reversing a global health workforce crisis. Bulletin of the World Health Organization, Geneva: 93:3. Available at: http://www.who.int/workforcealliance/media/news/2015/reversing_crisis/en/

The Economist (2012). Squeezing out the doctor. The role of physicians at the centre of health care is under pressure. Retrieved from http://www.economist.com/node/21556227.

The Guardian (2014). Task shifting explained: a viable solution to health worker shortage?, Retrieved from https://www.theguardian.com/global-development-professionals-network/2014/may/12/task-shifting-health-development-shortage.

Leadership and governance

Greer L S., Wismar M., Figueras J. (2016). Strengthening Health System Governace. Better policies, stronger performance. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0004/307939/Strengthening-health-system-governance-better-policies-stronger-performance.pdf.

Busse R., von der Grinten T., Svensson P. (2002). Regulating entrepreneurial behaviour in hospitals: theory and practice. In Saltman R. B., Busse R., & Mossialos, E. (Eds.), Regulating entrepreneurial behaviour in European health care systems, pp. 126-146. Buckingham: Open University Press.


Masseria C., Irwin R., Thomson S., Gemmill M. & Mossialos E. (2009). Primary care in Europe. Policy brief. Retrieved from https://lms.fu-berlin.de/bbcswebdav/pid-3266487-dt-content-rid-5323452_2/courses/CUB_BSPH_Sem2_HPE1/LSE%20%282009%29%20Primary%20care%20in%20Europe_policy%20brief.pdf.

OECD (2017). Health at a Glance 2015: OECD Indicators. Paris: OECD Publishing. Retrieved from http://www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm

Medical products and technologies

Panteli D, Arickx F, Cleemput I, Dedet G, Eckhardt H, Fogarty E, Gerkens S, Henschke C, Hislop J, Jommi C, Kaitelidou D, Kawalec P, Keskimäki I, Kroneman M, Lopez Bastida J, Pita Barros P, Ramsberg J, Schneider P, Spillane S, Vogler S, Vuorenkoski L, Wallach Kildemoes H, Wouters O, Busse R. (2016). Pharmaceutical regulation in 15 European countries: Review. Health Systems in Transition, 18(5):1–118, http://www.euro.who.int/en/about-us/partners/observatory/publications/health-system-reviews-hits/full-list-of-country-hits/special-edition-pharmaceutical-regulation-in-15-european-countries-2016.

Coverage and access

World Health Organization (2013). Research for Universal Health Coverage. Available at: http://apps.who.int/iris/bitstream/10665/85761/2/9789240690837_eng.pdf?ua=1

Evans B. D., Hsu J., Boerma T. (2013). Universal health coverage and universal access. Bulletin of the World Health Organization, 91, 546-546A. doi: http://dx.doi.org/10.2471/BLT.13.125450 [PDF]

Cotlear, D., Nagpal S., Smith O., Tandon A., Cortez R. (2015). Going Universal: How 24 Developing Countries are Implementing Universal Health Coverage Reforms from the Bottom Up. Washington, DC: World Bank.


Legido-Quigley H., McKee M., Nolte E., A Glinos I. (2008). Quality of care: an overview. In Legido-Quigley H., McKee M., Nolte E., A Glinos I. (Eds.), Assuring the quality of health care in the European Union, pp. 1-15. Geneva: WHO Press.

Financial protection

Moreno-Serra R., Millett C., Smith P. C. (2011). Towards improved measurement of financial protection in health. PLoS Med, 8(9), e1001087.

Saksena P, Hsu J, Evans DB (2014) Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges. PLOS Medicine 11(9): e1001701. https://doi.org/10.1371/journal.pmed.1001701

Thomson S., Figueras J., Evetovits T., Jowett M., Mladovsky P., Maresso A., Cylus J., Karanikolos M., Kluge H. (2014). Economic crisis, health systems and health in Europe: impact and implications for policy. Policy summary. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0008/257579/Economic-crisis-health-systems-Europe-impact-implications-policy.pdf?ua=1.

Improved Health

Murray, C. J., Salomon, J. A., & Mathers, C. (2000). A critical examination of summary measures of population health. Bulletin of the World Health Organization, 78(8), 981-994. http://apps.who.int/iris/bitstream/10665/57524/1/99-0102.pdf

Mackenbach, Johan P., et al. "Using ‘amenable mortality’as indicator of healthcare effectiveness in international comparisons: results of a validation study." J Epidemiol Community Health (2012): jech-2012. https://www.researchgate.net/publication/231212106_Using_'Amenable_Mortality'_as_Indicator_of_Healthcare_Effectiveness_in_International_Comparisons_Results_of_a_Validation_Study


Cylus, J., Papanicolas, I., & Smith, P. C. (2016). A framework for thinking about health system efficiency. Health System Efficiency, 1. http://www.euro.who.int/__data/assets/pdf_file/0004/324283/Health-System-Efficiency-How-make-measurement-matter-policy-management.pdf?ua=1#page=24


Busse, R. (2013). Understanding satisfaction, responsiveness and experience with the health system. Health System Performance Comparison: An Agenda for Policy, Information and Research, 255-80. http://www.euro.who.int/__data/assets/pdf_file/0009/244836/Health-System-Performance-Comparison.pdf

Health System Performance Assessment

Papanicolas I, Smith P (2013): Health system performance comparison: an agenda for policy, information and research. Policy summary , 4 . Open University Press, Maidenhead, UK. http://eprints.lse.ac.uk/54802/1/__libfile_REPOSITORY_Content_Papanicolas,%20I_Health%20system%20performance_Papanicolas_Health%20system%20performance_2013.pdf


block course for 2 weeks
C 313
Prof. Dr. Reinhard Busse
Dr. Wilm Quentin

Please note that the course will be held as a block course with lectures starting at 9am. Unless otherwise indicated, the course is held in C313. Please note, that we also offer a social programme for the two weeks (for instance on Tuesday, November 21st). This is a preliminary schedule of the course.

The following topics are going to be adressed this year:

Introduction and Outline of the course (15:00-17:00 Uhr)


Introduction and frameworks (09:00-12:00 Uhr)
Financing I: Raising resources (13:30- 17:00 Uhr)
Networking event (from 19:00 Uhr onwards)

Seminar on health system relevant databases and information for term paper (10:00-12:00 Uhr)
Financing II: Pooling and re-allocation (13:30-17:00 Uhr)

Financing III: Purchasing and payment systems (09:00-12:00 Uhr)
Leadership and Governance + Care Delivery (13:30-17:00 Uhr)

Medical products (09:00-12:00 Uhr)
Introduction to group exercise (10:30-12:00 Uhr)
Workforce (13:30-17:00 Uhr)
Preliminary Summary of building blocks (09:00-10:30 Uhr)
Presentation by the Deutsche Gesellschaft für
Internationale Zusammenarbeit (GIZ) on health cooperations worldwide (10:30-12:00)

Access and coverage (13:30-17:00 Uhr)

Quality and Safety (09:00-12:00 Uhr)
Financial and Social Risk Protection (13:30-17:00 Uhr)

Group work to prepare for presentation
Improved Health (13:30-17:00 Uhr)

Efficiency and Responsiveness (09:00-12:00 Uhr)
Summary of Health System Performance Assessment (13:30-17:00 Uhr)
Presentations and Wrap-up (09:00-12:00 Uhr)

Students wishing to receive a graded certificate

Please choose a country (your own, one you have recently been to, are currently in or are about to go). Describe and analyse the health care system in that country along the following lines:

  1. Outline the organization, regulation and financing of health care. Please be sure to incorporate a discussion of the various actors, the various functions of health care systems (resource generation, pooling etc.) and on the public-private mix as discussed during the course.
  2. What, if any, major reforms have been introduced recently or are about to be introduced? What will be the likely effect on the population and the various actors?
  3. What, in your opinion, are the main problems currently facing the health care system? Are they appropriately addressed by current health care reforms?

Be sure to make good use of the material collected during the course (slides and reading material) as well as other material, especially that provided by the European Observatory on Health Systems and Policies.
Please aim at a length of approx. 3000-4000 words. Assignments must be submitted in English.
Deadline: 31.05.2018; submission per email to

Zusatzinformationen / Extras