HP402      Half Unit
Measuring Health System Performance

This information is for the 2019/20 session.

Teacher responsible

Dr Irene Papanicolas COW 3.05


This course is compulsory on the MSc in International Health Policy. This course is available on the MSc in Global Health Policy, MSc in Health Policy, Planning and Financing and MSc in International Health Policy (Health Economics). This course is available as an outside option to students on other programmes where regulations permit.

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


15 hours of lectures, 9 hours of seminars and 5 hours of workshops in the LT.

Teaching will be delivered as 10 lectures of 1.5 hours, plus 6 seminars of 1.5 hours and 2 workshops of 2.5 hours

Indicative reading

Papanicolas I, Smith P (Eds) Health System Performance Comparison: An Agenda for Policy, Information and Research. Maidenhead: Open University Press, 2013;

P 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


Presentation (20%) and coursework (30%, 1000 words) in the LT.
Essay (50%, 3000 words) in the ST.

The coursework consists of a written policy brief based on the group presentations.

This is a similar course as HP402 Measuring Health System Performance (modular) but it has different teaching and assessment arrangements.

Student performance results

(2015/16 - 2017/18 combined)

Classification % of students
Distinction 12.3
Merit 76.9
Pass 6.2
Fail 4.6

Key facts

Department: Health Policy

Total students 2018/19: 62

Average class size 2018/19: 15

Controlled access 2018/19: No

Value: Half Unit

Guidelines for interpreting course guide information