SA4G6      Half Unit
Measuring Health System Performance

This information is for the 2015/16 session.

Teacher responsible

Dr Irene Papanicolas COWG.04


This course is available on the Executive MSc in Health Economics, Policy and Management and MSc in Health Economics, Outcomes and Management in Cardiovascular Sciences. This course is not available as an outside option.

Course content

This course aims to present a framework to discuss the opportunities and challenges with performance measurement in health care, examine the various dimensions and levels of health system performance, identify the measurement instruments and analytic tools needed, and examine the implications of these issues for policy makers and regulators. Lectures generally focus on measuring health system performance in high-income countries but draw on the experience of other countries where relevant.

After taking this course students are expected to:

• understand the principles of performance measurement

• appreciate the challenges, approaches, and opportunities in performance measurement in four dimensions: population health, patient outcomes, equity, quality and appropriateness of care, and productivity

• understand the methodological issues facing performance measurement relating to risk adjustment, developing composite measures, and measuring attribution and causality

• identify key issues relevant to policy makers relating to: developing targets and reporting on progress to the public, and developing incentives to improve performance


2 lectures (2 hours), 4 lectures (1.5 hours) and 5 seminars (2 hours).

Formative coursework

In-class exercise during seminar time. Students will receive feedback on it from their seminar leader after completion.

Indicative reading

Papanicolas I and Smith PC (Eds), Health System Performance Comparison: An agenda for policy, information and research. Maidenhead: Open University Press, 2013.

PC Smith, E Mossialos, I Papanicolas S. Leatherman (Eds), Performance measurement for health system improvement: experiences, challenges and prospects. Cambridge University Press, 2010;

Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC, National Academies Press, 2001;

OECD, Measuring up: improving health system performance in OECD countries. Paris: OECD, 2002.

World Health Organization (WHO), (2000) The world health report 2000:Health systems: Improving performance, Geneva: WHO Publications

Students will be given access to essential readings before the course begins through the pre-sessional reading programme on Moodle, which they will be expected to read prior to the first day of class.


Essay (75%, 3000 words) and in class assessment (25%).

In-class assessment (25%) and assessed piece of coursework (75%). In-class assessment on a presentation where students apply principles taught to construct an argument around a theory-based question informed from real world data. They would be assessed on their presentation as well as their ability to apply the conceptual material taught in class to practical data. Coursework is the production of a report where students are asked to evaluate and interpret key performance data for a particular country.

Student performance results

(2011/12 - 2013/14 combined)

Classification % of students
Distinction 10.8
Merit 64.6
Pass 23.1
Fail 1.5

Key facts

Department: Social Policy

Total students 2014/15: Unavailable

Average class size 2014/15: Unavailable

Controlled access 2014/15: No

Value: Half Unit

Guidelines for interpreting course guide information