There remain other key gaps where economists might
contribute more to improve the performance of the health
sector. In terms of Williams’s framework, there is a significant
need for more economics research and commentary
on issues relating to:
• what is health and what is its value? little research
having been done on this topic since the late 1990s
[48],
• the demand for health care, including health seeking
behaviour,
• the supply of health care, in particular an understanding
of the drivers of hospital productivity,
• micro-economic evaluation at treatment level, i.e.
better information and analyses to support cost-effectiveness
and prioritisation decisions beyond medicines,
especially New Zealand-specific information; and,
• at the system level, analyses of variations in use of
services and stronger incentives to manage these; an
understanding of the impact of recent primary health
care reforms and alternative models of care, and their
impact on health, hospital admissions, and overall
expenditures; and the outcomes achieved from the
range of services delivered—New Zealand has no focus
on patient-reported outcomes as is developing in other
countries [49], but we cannot effectively assess the
relative value for money generated by different services
or service providers without such a focus.
Conflicts of interest None.
Funding for the paper None.