Economic evaluation of health programmes Department of Epidemiology, Biostatistics and Occupational Health Class no. 4: Measuring costs - Part 1 Sept 15,

Slides:



Advertisements
Similar presentations
Learning Objectives Delineate the nature of a firm’s cost – explicit as well as implicit. Outline how cost is likely to vary with output in the short run.
Advertisements

Chapter 9: Production and Cost in the Long Run
MICROECONOMICS: Theory & Applications
Demand and Elasticity A high cross elasticity of demand [between two goods indicates that they] compete in the same market. [This can prevent a supplier.
10 Output and Costs Notes and teaching tips: 4, 7, 23, 27, 31, and 54.
Chapter 6 Production and Cost
Chapter 8 – Costs and production. Production The total amount of output produced by a firm is a function of the levels of input usage by the firm The.
Production and Costs.
Chapter 8: Production and Cost in the Short Run McGraw-Hill/Irwin Copyright © 2011 by the McGraw-Hill Companies, Inc. All rights reserved.
Chapter 8: Production and Cost in the Short Run McGraw-Hill/Irwin Copyright © 2011 by the McGraw-Hill Companies, Inc. All rights reserved.
Production and Cost CHAPTER 12. When you have completed your study of this chapter, you will be able to C H A P T E R C H E C K L I S T Explain how economists.
Cost Analysis and Estimation
THEORY OF FIRM BEHAVIOR
C H A P T E R C H E C K L I S T When you have completed your study of this chapter, you will be able to Explain how economists measure a firm’s cost.
Economics 101 – Section 5 Lecture #13 – February 26, 2004 Introduction to Production.
Module 14 Cost in the Short Run.
ECNE610 Managerial Economics APRIL Dr. Mazharul Islam Chapter-7.
The Firm: Cost and Output Determination
The Theory and Estimation of Cost
CHAPTER 8 Short-Run Costs and Output Decisions © 2009 Pearson Education, Inc. Publishing as Prentice Hall Principles of Economics 9e by Case, Fair and.
Lecture 9: The Cost of Production
McGraw-Hill/Irwin © 2005 The McGraw-Hill Companies, Inc., All Rights Reserved. Supply Decisions.
Chapter 10 Production Profit Definitions. What is a firm? A firm is a business organization that brings together and coordinates the factors of production.
Costs of Production Mr. Bammel. Economic Costs  Businesses have costs for the same reason that consumers do: Scarcity; Essentially the resources that.
Eco 6351 Economics for Managers Chapter 5. Supply Decisions
Lecturer: Kem Reat Viseth, PhD (Economics)
Supply Decisions Chapter 5 Copyright © 2011 by The McGraw-Hill Companies, Inc. All Rights Reserved.McGraw-Hill/Irwin.
The Costs of Production
Production and Cost Analysis I 12 Production and Cost Analysis I Production is not the application of tools to materials, but logic to work. — Peter Drucker.
Mohammad S. A. Khan Mamun, PhD Department of Economics Cost of Production & Cost Curves.
By: Christopher Mazzei. Viewpoints The owner of a company wants to keep costs down. An employee of the company wants a high wage or salary. There is always.
The Costs of Production
Chapter 23: The Firm - Cost and Output Determination
PART II The Market System: Choices Made by Households and Firms © 2012 Pearson Education Prepared by: Fernando Quijano & Shelly Tefft CASE FAIR OSTER.
The Costs of Production
9.1 Chapter 9 – Production & Cost in the Short Run  Our focus has been on the fact that firm’s attempt to maximize profits. However, so far we have only.
The Cost Structure of Firms Chapter 6
Before We Start…Group Presentation
Copyright©2004 South-Western The Costs of Production.
The Firm and Cost Overheads. Costs in the short run Total cost — everything they must give up in order to produce output A firm’s total cost of production.
COSTS OF THE CONSTRUCTION FIRM
The Costs of Production Chapter 6. In This Chapter… 6.1. The Production Process 6.2. How Much to Produce? 6.3. The Right Size: Large or Small?
Supply: The Costs of Doing Business CHAPTER 8 © 2016 CENGAGE LEARNING. ALL RIGHTS RESERVED. MAY NOT BE COPIED, SCANNED, OR DUPLICATED, IN WHOLE OR IN PART,
Chapter 23 The Firm: Cost and Output Determination.
Cost Theory and Estimation Dr Nihal Hennayake
Chapter 7 The Theory and Estimation of Cost. Copyright ©2014 Pearson Education, Inc. All rights reserved.7-2 Chapter Outline Importance of cost in managerial.
Principles of Microeconomics : Ch.13 Second Canadian Edition Chapter 13 The Costs of Production © 2002 by Nelson, a division of Thomson Canada Limited.
Economics Today Chapter 22 The Firm: Cost and Output Determination
The Costs of Production. How firms compare revenues and costs in determining how much to produce?  Explicit and implicit costs  Law of diminishing returns.
Chapter 6: Production and Cost Econ 101: Microeconomics.
Chapter SevenCopyright 2009 Pearson Education, Inc. Publishing as Prentice Hall. 1 Chapter 7 The Theory and Estimation of Cost.
Production and Cost CHAPTER 13 C H A P T E R C H E C K L I S T When you have completed your study of this chapter, you will be able to 1 Explain how.
1 Production, Costs, and Supply Principles of Microeconomics Professor Dalton ECON 202 – Fall 2013.
CHAPTER 8 Short-Run Costs and Output Decisions © 2009 Pearson Education, Inc. Publishing as Prentice Hall Principles of Economics 9e by Case, Fair and.
Cost Curve Model Chapter 13 completion. Costs of Production Fixed costs - do not change with quantity of output Variable costs - ↑ with quantity of output.
When you have completed your study of this chapter, you will be able to C H A P T E R C H E C K L I S T Explain how economists measure a firm’s cost of.
Chapter 23 The Firm: Cost and Output Determination.
TUMAINI UNIVERSITY FACULTY OF BUSINESS ADM Managerial Economics G. Loth.
1 of 34 PART II The Market System: Choices Made by Households and Firms © 2012 Pearson Education 8 Short-Run Costs and Output Decisions CHAPTER OUTLINE.
Producer Choice: The Costs of Production and the Quest for Profit Mr. Griffin AP ECON MHS.
8-1 Learning Objectives  Explain general concepts of production and cost analysis  Examine the structure of short-run production based on the relation.
1 Thinking About Costs A firm’s total cost of producing a given level of output is the opportunity cost of the owners – Everything they must give up in.
Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.
© 2009 Pearson Education, Inc. Publishing as Prentice Hall Principles of Economics 9e by Case, Fair and Oster 8 PART II THE MARKET SYSTEM Choices Made.
1 Module 14 Cost in the Short Run. Objectives:Objectives:  Understand the relationship between the short run production function and short run costs.
Chapter 20 The Costs of Production
PowerPoint Lectures for Principles of Economics, 9e
Chapter 8 Production and Cost in the Short Run
8 Short-Run Costs and Output Decisions Chapter Outline
Presentation transcript:

Economic evaluation of health programmes Department of Epidemiology, Biostatistics and Occupational Health Class no. 4: Measuring costs - Part 1 Sept 15, 2008

Plan of class  Finish review of Mark et al; review Weisbrod et al. using checklist from chapter 3.  Average, marginal, fixed, variable, total costs  Calculating unit costs without overhead costs to allocate between different clinical activity centres  Calculating unit costs when overhead or joint costs need to be allocated

Checklist summary (1)  Does the question correspond to the economic evaluation of a health program?  Was a comprehensive description of the alternatives given?  Was the effectiveness of the program or intervention or treatment well established?  Were all important and relevant costs and consequences for each alternative identified?  Were costs and consequences measured accurately in appropriate physical units?

Checklist summary (2)  Were costs and consequences valued credibly?  Were costs and consequences adjusted for differential timing?  Was an incremental analysis of costs and consequences of alternatives performed?  Was allowance made for uncertainty in the estimates of costs and consequences?  Did the presentation of study results include all issues of concern to users?

Question  How does the viewpoint of the analysis influence the conclusion in Weisbrod et al.’s analysis? Does the E treatment produce a net benefit from the point of view of the health and social care system?

Total, average, marginal, fixed and variable costs

HYPOTHETICAL TOTAL, AVERAGE, AND MARGINAL COSTS OF AN ORTHOPAEDIC SURGEON SPECIALIZED IN HIP REPLACEMENTS Surgeries per week Total cost (dollars) Marginal cost (dollars) Average cost (dollars)

TOTAL, AVERAGE AND MARGINAL COSTS - GRAPHICALLY $ TOTAL COSTAVERAGE COST Surgeries MARGINAL COST

FIXED AND VARIABLE COSTS Another important way of classifying costs is between fixed and variable. Fixed costs are those that are incurred in a fixed way (do not change) whatever the level of production. All other costs, which vary with the level of production, are called variable costs. Thus we have the relation: TC = TFC + TVC (total costs = total fixed costs + total variable costs)

What goes into the marginal cost, for a hospital, of an additional X- ray? How does it compare to the average cost of an X-ray? How about the variable cost of an X- ray?

HYPOTHETICAL FIXED COSTS OF AN ORTHOPAEDIC SURGEON SPECIALIZED IN HIP REPLACEMENTS Surgeries per week Total fixed cost (dollars) Marginal fixed cost (dollars) Average fixed cost (dollars)

TOTAL, AVERAGE AND MARGINAL FIXED COSTS - GRAPHICALLY $ TOTAL FIXED COST AVERAGE FIXED COST Surgeries MARGINAL FIXED COST Total fixed costs do not change once production has begun. Average fixed costs will keep declining, but without ever reaching 0. Marginal fixed cost starts at 5000 with the first unit, then goes to 0. All this follows from the definition of fixed costs.

REVISITING TOTAL, AVERAGE AND MARGINAL COSTS $ TOTAL COSTAVERAGE COST Surgeries MARGINAL COST The total cost function can never be decreasing. If the marginal cost curve intersects the one for average cost, at that point average cost reaches a minimum and then begins to rise. Can you see why?

LONG-RUN VERSUS SHORT- RUN COSTS The cost to a hospital or other organization of changing its output level is very much dependent on the time horizon for the change. Given enough time, a hospital can change many of its inputs so as to be able to more efficiently produce the greater quantity. For example, robotic equipment can be purchased to automate a surgical procedure. The long run is a period of time long enough for all the hospital’s commitments to come to an end. The short run is a shorter period of time than the long run, such that some, but not all, of its commitments will have come to an end. In the long run, virtually all fixed costs become variable.

LONG-RUN VERSUS SHORT-RUN AVERAGE COST CURVES Short-run AC curves Long-run AC curve In the short run, the producer is “stuck” with one production method or another, each associated with one of the short-run AC curves. But in the long run, depending on the desired level of output, the producer can choose the production method leading to the lowest AC.

Cost = q x p Price of one pill = $25 Price of three pills = 3 x $25 = $75 To cost resources we need to : (a) count numbers or frequencies; then (b) multiply them by a unit cost

Note: ignore minor costs or costs that won’t change the answer  Some costs far into the future, because of discounting…  Costs that are small compared to the others and perhaps difficult to measure  Ex: Legal costs for certain populations of people with severe mental illness

In theory, what should the unit cost represent?  Short-run or long-run opportunity cost of using the resource?  Usual practice: estimate average cost, as an approximation to the long-run marginal cost  Exception: when comparing two programs that have the same overhead costs

Need for caution in using average costs  The case of Info-Santé

So how do we find a unit cost?

Easy if we live in England… Unit Costs of Health and Social Care 2007 Personal Social Services Research Unit (PSSRU), University of Kent at Canterbury pdf

But what if we live in Canada?  No current, comprehensive set of unit costs  Would vary significantly by province  Price, when it exists, is usually a good approximation  In U.S., hospital prices can be very misleading  In the Québec health care system, what services have a price?

Why market price may not be good  Under what conditions does market price reflect the cost of production?

Volunteer time  Common practice: ignore it, or report it separately as time  If valued:  Wage rate of someone who could be hired to do the job  Average wage rate for age and sex  Which seems best to you?

No joint costs to allocate (1)  Uncommon in health care: an organization that produces only one output Nursing home with one level of care

No joint costs to allocate (2)  Divide total cost by number of units produced  Ex: Total cost in : $5,000,000 (including estimate of opportunity cost of land and building)  Number of bed-days: 40,000  Cost per bed-day: $125

Allocating joint costs: the problem Cost of Hospital’s central administration: $2M 35,000 bed- days 150,000 Outpatient visits ??

No simple solution!  Allocation method depends on objective – no « true » or absolutely « correct » way to do it  For us: look for reasonable method  Consider Tables 4.2 to 4.8