Health Policy and Administration PhD Track in Health Services and Policy INTRODUCTION The Health Policy and Administration (HPA) Division of the UIC School of Public Health offers a PhD track in Health Services and Policy. The track s primary objective is to provide students with the conceptual and analytical skills needed to pursue research careers in academia, contract research organizations, consulting firms, government, or industry. Within this track there are two recommended concentrations: 1) health services and outcomes research - designed to provide the research skills necessary to study the organization, access, financing, and delivery of health services and (2) health economics research - designed to provide the research skills in economic theory, cost analysis, and econometrics necessary to examine the policies that affect the behavior of health care institutions, providers, and individuals that in turn influence population health. PROGRAM OVERVIEW A minimum of 96 credit hours are required for the PhD degree. Of these, 32 credit hours are allocated to thesis research. The remaining 6 credit hours are devoted to coursework. During the first year of doctoral studies, the student will take a common core of coursework with other first year students (regardless of intended concentration). Students can enter the doctoral program with a bachelor s degree, but will be strongly encouraged to remediate a math deficiency by the end of the first year. In the second year, students will be encouraged to choose their intended concentration and pursue coursework in that area. As some students may already have a master s degree, on a selective basis and only with consent of the HPA Director of Doctoral Studies students will be permitted to transfer credit for relevant courses of up to 32 credit hours, based on appropriateness of prior coursework. ACADEMIC ADVISEMENT The academic advisor for all doctoral students will be the HPA Director of Doctoral Studies until the student has successfully completed his or her core coursework and preliminary examination. At that time, the student may transfer to an appropriate advisor in HPA who will mentor them in further coursework and the writing of the dissertation proposal and the conduct of the dissertation. This advisor typically also serves as the chair of the candidate s dissertation committee. CURRICULUM OBJECTIVES 1
The Health Services and Policy track is designed to prepare students with the research skills that are necessary to study the complex systems involved in the organization, access, financing, and delivery of health services and policies. Coursework should typically involve 500-level courses available at any of the colleges within UIC. At the end of their doctoral work, the following objectives will have been accomplished: A. Demonstrate knowledge of the following theoretical and historical foundations: 1. Student should have an overview of the history of health services research and its role in the public policy making process and present theoretical frameworks, data sources, research methods, and substantive findings regarding the major issues in health services research access, quality, and the cost, financing and effectiveness of health services. 2. Students should understand the philosophy of science and theories and models relevant to health services research including: the Health Belief Model, Popper s falsificationism, Kuhn s theory of scientific change, Anderson s model of health care utilization, Donabedian s structure, process, outcome model for quality, Prochaska and DiClementi s stages of change, and Grossman s health capital model. 3. Students should understand the organization, development, and financing of the US health service system and its components and the definition of health and its broader determinants. B. Demonstrate the following analytical skills including experience in the relevant computer software: 1. Advanced statistical methods appropriate for the study of secondary data such as, multivariate regression analysis, analysis of limited dependent variables, and instrumental variables methods. 2. Study designs that include randomized and quasi-experimental designs. The process of selecting a study design should include a thorough consideration of the types of validity, the threats to validity and the other strengths and weaknesses of each design, and of their relative importance and applicability to the specific study. 3. Microeconomic concepts and techniques including cost-benefit and costeffectiveness analysis in the evaluation of health programs and policies.. Survey research design, implementation and analysis. 2
5. Program evaluation and policy analysis including secondary analysis of existing data sets. TEACHING Each student will be required to gain experience in teaching at the university level and to teach a significant component of a course in the Health Policy and Administration Division. PRELIMINARY EXAMINATION The preliminary examination should be undertaken as soon as possible after completion of the required program of study. The preliminary examination is generally administered at the time the student has completed most, though not necessarily all, of his or her coursework, but has not made a major investment of time and effort towards the dissertation research project typically after two years of fulltime coursework. A minimum of one year should elapse between the passing the preliminary examination and the defense of the dissertation. Only students in good academic standing are permitted to take the examination. The preliminary examination is a two-part examination. First is a written exam based on the curriculum objectives, and second is an oral defense of the written exam. The preliminary examination will include questions on health services research history and theory; philosophy of science; research design, measurement, statistics and other analytical methods; and microeconomics, all in the context of the health services system. The examination will be prepared by HPA s PhD Preliminary Examination Committee and will be administered in late August (approximately the first week of the fall semester). The oral defense will be scheduled by the committee shortly after the written component (and no more than one month later than the written component). The exact format will be determined each year by the end of the spring semester by the HPA Preliminary Examination Committee and a reading list will be distributed at that time. If the student s preliminary examination work is given a failing grade, the student will be granted one opportunity to re-take the examination. An examination will be scheduled (if necessary) for the first week of December A second failure will result in a recommendation from the Preliminary Examination Committee that the student be terminated from the program. DISSERTATION After successfully completing the preliminary examination, the student, in conjunction with the HPA Director of Doctoral Studies, will select a dissertation chair and Dissertation Examining Committee. This committee consists of five members, at least two of whom must be tenured faculty members, and one who is from outside the Division. The dissertation advisor, who must be from HPA, serves as chair of the committee and must be a member of the UIC Graduate College faculty. After approval of the Graduate College, this committee will be 3
responsible for conducting the Dissertation Proposal Defense and final Dissertation Defense. The Dissertation Proposal Defense, given orally by the Dissertation Examining Committee, serves two primary functions: To ascertain whether the student is adequately prepared to pursue the dissertation topic. If deficiencies are discovered, additional coursework may be required. To indicate to the student whether the Dissertation Examining Committee feels that the proposed research is feasible and whether the research should result in a useful, satisfactory product within the time and resources available. The Dissertation Proposal Defense should not put the student into a pass-fail situation. Rather, it should, when necessary, guide the student into a more feasible and/or fruitful research plan. It is strongly recommended that not more than two semesters elapse following passage of the preliminary examination before approval of the dissertation proposal. The major advisor will notify the Division Director and the Director of Graduate Studies when the Dissertation Proposal Defense has been judged as satisfactory. The Examining Committee and the student should be in agreement on all major elements of the research proposal to be carried out by the candidate. The student s research is carried out under the guidance of a dissertation advisor and Dissertation Examining Committee. The research must be creative and original, advancing a field of health services research/health policy research by adding significant new knowledge to the existing body of research. Completion of the assigned research credit does not guarantee an acceptable dissertation; additional research effort may be necessary. The dissertation may be presented in the traditional thesis format or may be one or more manuscripts of publishable quality with respect to peer-reviewed journals. The specific requirements for both are to be established by the dissertation committee in accordance with Graduate College requirements. Both a final examination and dissertation presentation are required. This typically takes the following format. The candidate presents his/her findings at an open meeting of faculty, students, and the Dissertation Committee. Immediately following the open session the committee meets with the student in executive session. Finally, the Dissertation Examining Committee reports to the Graduate College whether the student has passed his/her examination not and thus whether all requirements for the PhD degree have been satisfied. Upon approval of the Director of Doctoral Studies, the student is recommended to the Graduate College for award of the degree.
Subjects and Examples of Courses for the PhD in Health Services and Policy Under direction of the academic advisor, each student must complete appropriate courses that address the curriculum objectives. Students will be expected to take additional courses in their area(s) of focus, e.g., economics, qualitative research, measurement, survey research, program evaluation. The specific courses taken to achieve curriculum objectives must be approved by the Director of Doctoral Studies. A Model Curriculum follows: CORE CURRICULUM YEAR 1 Area of competency History and Theory Statistics and Epidemiology Curriculum Subjects Overview of the history of health services research. Presents theoretical frameworks and substantive findings regarding the major issues in health services research--access, quality, and the cost, financing and effectiveness of health services. A deeper investigation into the recent history of health services recent, theory, and methods. Descriptive statistics, basic probability concepts, one- and two-sample statistical inference, analysis of variance, and simple linear regression. Introduction to statistical data analysis software. Simple and multiple linear regression, stepwise regression, multifactor analysis of variance and covariance, non-parametric methods, logistic regression, analysis of categorical data; extensive use of computer software. Introduction to descriptive and analytic epidemiology, and determinants of health and disease in populations. Recommended courses HPA 59 Introduction to Health Services HPA 59 Advanced Health Services BSTT 00 Biostatistics I* BSTT 01 Biostatistics II* EPID 03 Introduction to Epidemiology: Principles and Credits Term 3 Fall 3 Spr Fall Spr 3 Fall/ Spr 5
Design and Measures of occurrence, association and statistical testing will be addressed, along with study designs, bias and confounding. Study designs that include randomized and quasiexperimental designs Principles, models and practical methods for the economic evaluation of health care services with an emphasis on pharmaceutical care. Examines empirical methods in health policy research. Examination of the role of government and government policies in the health care market from an economic perspective. HPA522 Public Health Design and 3 Fall HPA 573 3 Fall Principles of economic evaluation of health care interventions HPA 59 Spr Applied HPA 67 3 Spr Economics, Policy Analysis and Program Evaluation Total 30 *For students who have already taken BSTT 00 and BSTT 01 students will be encouraged to substitute the following courses: BSTT 505 Logistic Regression and Survival Analysis (2cr) BSTT 507 Sampling and Estimation Applied to Public Health (3cr) BSTT 537 Longitudinal Data Analysis (cr) Students without any prior economics coursework are encouraged to enroll in HPA60 Introduction to Health Economics (3cr) in the fall semester. In addition, students lacking a strong background in calculus and linear algebra will be encouraged to take: MATH 165, Calculus for Business (5cr) MATH 310, Applied Linear Algebra (3cr) Additionally: Chicago Metropolitan Exchange Program (CMEP), a new initiative between the University of Chicago, Northwestern University and UIC, allows doctoral students from the participating institutions may access courses at the other participating institutions. Students will be billed for courses taken through the CMEP at their home campus at its usual rate. 6
YEAR 2/3: HEALTH SERVICES/OUTCOMES CONCENTRATION Description Course Hours Term Measurement theory and its application. HPA557 3 Fall Measurement in Health Services Philosophy of science and theories and models relevant to health services research, such as: the Health Belief Model is introduced. CHS 551 Foundations of Public Health Inquiry 3 Fall Survey research design (includes survey sampling), implementation and analysis Program evaluation and/or policy analysis. Course may be chosen from several at UIC or may be done as a CIC traveling scholar. Interpretation of logistic regression and survival analysis models. Running logistic and proportional hazards regression models and constructing life-tables using SAS. Provide a comprehensive overview of current methods and issues in survey sample design and associated estimation procedures. Application and theory of models for longitudinal data analysis for both continuous and categorical response data, including use of statistical software for these methods. An advanced graduate-level course focused on the grant writing strategies with an emphasis on methodologies relevant to health services, economics and outcomes research. Basic qualitative research techniques and/or advanced management and analysis of qualitative data CHS7 Survey Planning and Design UPP588 Design and Evaluation or UPP58 in Policy Analysis BSTT 505 Logistic Regression and Survival Analysis BSST 507 Sampling and Estimation Applied to Public Health BSST 537 Longitudinal Data Analysis HPA 590 and Grant Writing 3 Fall Fall Spr 2 Fall 3 Spr Fall 3 Spr CHS 53 3 Spr Qualitative Data Analysis (opt) Total 25-30 7
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YEAR 2/3: HEALTH ECONOMICS CONCENTRATION Description Course Hours Term Application of mathematics to theories of consumer and producer behavior, determination of prices in markets, growth and stability features of macroeconomic models. ECON 36 Mathematical Economics (opt) Sum Theories of consumer and producer behavior and determination of market price. Systematic treatment of the core of microeconomic theory. Advanced microeconomic theory. Theories of consumer behavior, uncertainty, general equilibrium, welfare economics. Detailed treatment of the multivariate linear regression model using matrix algebra. Emphasis on formulating and testing static and dynamic econometric models. Prerequisite Detailed treatment of simultaneous equations estimation; evaluation of alternative estimators; problems of estimation including PROBIT, LOGIT, TOBIT and Error Component Models. Topics in the supply and demand for health services; the role of insurance in the medical care industry; public policy issues of cost and quality regulation. Application of econometric techniques to empirical problems in microeconomics with emphasis on issues of identification and causality; and the selection, implementation and testing of statistical models. An advanced graduate-level course focused on the grant writing strategies with an emphasis on methodologies relevant to health services, economics and outcomes research. ECON 501 Microeconomics I ECON 502 Microeconomics II ECON 53 Econometrics I ECON 535 Econometrics II ECON555 Advanced Health Economics I ECON 556 Advanced Health Economics II (opt) ECON 539 Microeconometrics (opt) HPA 590 and Grant Writing Fall Spr Fall Spr Fall Spr 3 Spr Total 23-35 9