1. Diverse economic methodologies and health system research
UK funders’ workshop on health policy and systems research in low and middle income countries
DFID/ ESRC/ Wellcome Trust
Maureen Mackintosh
Open University, UK
Professor Maureen Mackintosh, 14 Dec 2011

2. Professor Maureen Mackintosh, 14 Dec 2011
Two issues/ questions
We know many health systems are highly marketised and/or private sector dominated – what methodologies are needed to diagnose its extent and nature?
Health systems are major economic sectors producing goods and services – what methodologies are needed to understand their direction of change (dynamics)?
Professor Maureen Mackintosh, 14 Dec 2011

3. Diverse economic methodologies relevant to marketised health systems
1. Exploratory methodologies drawn from development economics, investigating economic systems through fieldwork.
2. Business and financial economics applied to industrial and service sectors, e.g. contracting, business strategy.
3. Evolutionary methodologies used in industrial economics to identify the drivers of changing market structure in industrial and service sectors.
Professor Maureen Mackintosh, 14 Dec 2011

4. Evolutionary methodology
Evolutionary
Traditional
Dynamics
Open, nonlinear, far from equilibrium
Closed static linear systems in equilibrium
Agents
Heterogeneous, rules of thumb for decisions with incomplete information, learn and adapt
Homogenous, use complex deductive calculations to make decisions, do not learn or adapt
Networks
Models interactions between agents; networks change over time
Assumes agents only interact indirectly through market mechanisms
Evolution
Co-evolutionary learning and differentiation: perpetual novelty in firms, strategies, technologies, markets.
No mechanism for endogenously creating novelty. Growth through increases in productivity.
Professor Maureen Mackintosh, 14 Dec 2011