Glossary

A–Z definitions of key terms used across the Health Economics Guide. Each entry gives a plain-English definition, an optional verified Wikipedia link, and a See Chapter N — Title pointer to the term's home chapter (the chapter that owns it per the manifest in spec/index.md §4).

Entries are alphabetical within each letter section. This file is populated as chapters are written; empty letter sections are placeholders.

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A

"A QALY is a QALY is a QALY" — The convention that a quality-adjusted life year counts equally whoever receives it; an equal-weighting rule that is itself a distributive value judgement, not a neutral technical default. — See Chapter 3.5 — Capabilities.

Accountability for reasonableness — A framework (Daniels and Sabin) for making priority-setting legitimate through four conditions: publicity, relevant reasons, revisability, and enforcement. — See Chapter 3.3 — Rationing.

Accountable care organization — A provider group given a budget and a stake in the outcomes and total cost of a defined population, aligning payment with the coverage an insurer is trying to deliver. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Activities of daily living (ADLs) — The basic self-care tasks — bathing, dressing, toileting, transferring, continence, feeding — whose limitation grades dependency and drives the cost of long-term care. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Active travel — Walking and cycling, a measure that cuts transport emissions and raises physical activity at once — a classic climate-and-health co-benefit. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Actuarial science — The discipline of estimating the cost and risk of future claims, on which every viable insurance design ultimately rests. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Adaptation (hedonic adaptation) — The tendency of people living with a health condition to adjust and recover much of their wellbeing, so patients often value a health state more highly than the public does. Wikipedia — See Chapter 3.5 — Capabilities.

Adverse event — An injury caused by medical management rather than by the underlying disease; the preventable, harmful subset is where the economics of safety concentrates. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

Adverse selection — The unravelling of a voluntary insurance pool when those who expect to claim are keenest to buy, raising premiums and driving out the healthy. Wikipedia — See Chapter 1.3 — Market Failure.

Advance market commitment (AMC) — A binding promise by funders to subsidize the future purchase of a product at a pre-agreed price and quality, used to pull private research towards diseases whose market is otherwise too small. Wikipedia — See Chapter 5.1 — Innovation Health Economics.

Affordability versus value — The distinction between whether an intervention is good value per patient (cost-effectiveness) and whether a payer can fund it across everyone eligible in the years the bill falls due (affordability). — See Chapter 2.5 — Budget Impact and Affordability.

Agency relationship (principal–agent problem) — The delegation of a decision from a patient (principal) to a clinician (agent) who knows more; a "perfect agent" recommends what the informed patient would choose. Wikipedia — See Chapter 1.2 — Demand for Health and Healthcare.

Air pollution — Contamination of the air, much of it from fossil-fuel combustion; cutting it reduces both greenhouse-gas emissions and immediate ill health. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Algorithmic bias — Systematic worse performance of a model for a subgroup, treated in health economics as an equity cost hidden by an average. Wikipedia — See Chapter 5.3 — AI Health Economics.

Antimicrobial resistance — The erosion of antibiotics' effectiveness through use, a slow-motion tragedy of the commons that ordinary markets deplete and under-fund. Wikipedia — See Chapter 1.3 — Market Failure.

Anxiety disorder — A common mental disorder that, at moderate individual severity but very high prevalence, contributes heavily to aggregate productivity loss. Wikipedia — See Chapter 3.9 — Mental Health Economics.

Arrow, Kenneth — Economist whose 1963 paper "Uncertainty and the Welfare Economics of Medical Care" is the founding diagnosis of health-care market failure. Wikipedia — See Chapter 1.1 — Introduction to Health Economics.

Artificial intelligence in health care — Computational systems, most consequentially machine-learning models, that perform tasks otherwise requiring clinical judgement. Wikipedia — See Chapter 5.3 — AI Health Economics.

Artificial Intelligence Act (EU) — The European Union's 2024 law classifying many medical AI systems as high-risk, adding a compliance cost that an AI business case must carry. Wikipedia — See Chapter 5.3 — AI Health Economics.

Attention economy — The recognition that in an information-rich world the scarce resource is attention; social media platforms are markets that allocate exposure by predicted engagement, which favours the emotive over the true. Wikipedia — See Chapter 4.4 — Social Media and Health Communication Economics.

Automation — The substitution or augmentation of human labour by machines; in health, whether AI replaces or assists a clinician determines where value comes from. Wikipedia — See Chapter 5.3 — AI Health Economics.

Automation bias — The human tendency to over-trust a machine's output and accept a wrong recommendation because it came from a computer. Wikipedia — See Chapter 5.3 — AI Health Economics.

Average cost — Total cost divided by output; in a hospital it typically sits well above marginal cost because so much of the cost is fixed. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

B

Baumol effect (cost disease) — The structural rise in the relative price of labour-intensive services such as health care, whose wages track a wider economy with faster productivity growth. Wikipedia — See Chapter 1.3 — Market Failure.

Behavioural economics — The study of how psychological, cognitive, and social factors make decisions depart systematically from the rational-choice model. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Behavioural Insights Team — The United Kingdom unit that pioneered applying evaluated behavioural science to public policy, a model many governments have since copied. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Benefit package — The explicit definition of which services, drugs, and providers an insurance scheme covers; the single most consequential design document a scheme produces, and an exercise in explicit priority-setting. — See Chapter 3.7 — Insurance and Risk Protection.

Beveridge model — A health system funded from general taxation and delivered through publicly owned providers, free at the point of use (e.g. the UK NHS). Wikipedia — See Chapter 3.1 — Health Systems.

Biosimilar — A close but not identical copy of a biologic medicine, judged clinically equivalent; competition lowers price but by less and more slowly than generics. Wikipedia — See Chapter 2.4 — Pharmacoeconomics.

Bismarck model (social health insurance) — A system funded by compulsory payroll contributions into non-profit sickness funds that pay a mix of providers (e.g. Germany). Wikipedia — See Chapter 3.1 — Health Systems.

Block contract — A contract paying a provider a fixed sum for a broadly defined service; the purchaser bears demand risk cheaply but the contract only weakly rewards activity. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Bounded rationality — Herbert Simon's insight that real decision-makers have limited attention and information, so they satisfice rather than optimize. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Budget impact analysis (BIA) — An estimate of the total, year-by-year financial consequences of adopting an intervention for a whole eligible population against a specific budget, distinct from and complementary to cost-effectiveness. — See Chapter 2.5 — Budget Impact and Affordability.

Business case for safety — The argument that investment in preventing harm pays for itself in avoided failure costs; genuinely uncomfortable because the budget that funds prevention is often not the one that reaps the saving. — See Chapter 3.11 — Quality and Safety Economics.

C

Capability approach — Sen's and Nussbaum's framework valuing the real freedoms a person has to do and be what they value, rather than resources, utility, or health states alone. Wikipedia — See Chapter 3.5 — Capabilities.

Capacity utilization — How fully a provider's fixed plant is used; central to cost per case, with an optimum that is deliberately below full because standing ready has value. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Capital expenditure — A large fixed cost incurred up front and recovered, if at all, through years of use; converts flexible budget into standing commitment and creates pressure to feed the asset. Wikipedia — See Chapter 5.5 — Robotics Health Economics.

Capitation — Paying a provider a fixed sum per enrolled person per period regardless of activity; rewards prevention and restraint but risks under-provision. Wikipedia — See Chapter 3.1 — Health Systems.

Carbon footprint — The total greenhouse-gas emissions attributable to producing and delivering care, split into direct (Scope 1), purchased-energy (Scope 2), and supply-chain (Scope 3) emissions. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Care work — Paid or unpaid work of caring for dependent people, whose valuation is essential to honest long-term-care analysis. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Caregiver — A family member or friend who provides unpaid support to a dependent person, bearing real costs in forgone earnings, pension, and health that rarely appear in any account. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Causal inference — The attempt to establish that a change in one thing causes, rather than merely moves with, a change in another. Wikipedia — See Chapter 2.3 — Health Econometrics.

Choice architecture — The design of the environment in which people make decisions; whoever shapes it is the choice architect. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Climate change mitigation — Action to cut greenhouse-gas emissions — including decarbonizing health estates, supply chains, and care models — as distinct from adaptation to climate impacts. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Clinical decision support system — Software that recommends, ranks, or flags information to a human clinician rather than deciding autonomously. Wikipedia — See Chapter 5.3 — AI Health Economics.

Co-benefits (of climate action) — Gains in more than one domain from a single measure, as when cleaner air or active travel cuts emissions and improves health at once. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Co-dependent technology — A drug and its selection test (or any linked pair) whose value cannot be assessed separately because neither delivers its benefit alone. — See Chapter 5.1 — Innovation Health Economics.

Coalition for Epidemic Preparedness Innovations (CEPI) — A partnership that finances vaccine platforms and candidates against epidemic threats, an institutional way to hold standing preparedness capacity. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Cochrane — The international collaboration whose Handbook is the standard manual for systematic reviews and whose reviews are a global reference point. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

Coinsurance — A form of cost-sharing in which the insured pays a fixed percentage of each bill, so their exposure rises with the cost of care. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Commercial determinants of health — The ways private-sector products, marketing, supply chains, and lobbying — in tobacco, alcohol, ultra-processed food, and gambling — shape health, often adversely and at a profit that is privatized while the harm is socialized. Wikipedia — See Chapter 1.5 — Determinants of Health.

Commissioning — The practical expression of strategic purchasing: assessing a population's needs, planning and procuring services, and monitoring what is delivered. Wikipedia — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Commissioning cycle — The continuous loop of assess, plan and prioritize, procure and contract, then monitor and review — the discipline that makes purchasing ongoing rather than a one-off tender. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Community rating — Charging everyone in a pool the same premium regardless of individual health risk, so the healthy subsidize the sick and coverage stays affordable for those most likely to need it. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Companion diagnostic — A test that identifies which patients should receive a particular treatment, so the two are evaluated and used together. — See Chapter 5.1 — Innovation Health Economics.

Compensating differential — The extra pay a worker requires to accept worse conditions — night shifts, danger, an unpopular rural posting; unpaid, it yields a predictable shortage. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Compulsory licence — A lawful override of a patent letting a country authorize a generic version of a medicine, affirmed for public-health need by the Doha Declaration. Wikipedia — See Chapter 4.2 — Global Health and Trade.

Concentration index and curve — Tools that rank a population from poorest to richest and summarize how far health, illness, or care use is concentrated among rich or poor. — See Chapter 3.4 — Equity.

Concept drift — The silent decay of a model's performance as the population or practice it meets diverges from its training data. Wikipedia — See Chapter 5.3 — AI Health Economics.

Condition-specific measure — An outcome instrument tuned to one disease area, sensitive to changes a generic measure misses but not comparable across conditions and rarely yielding a utility value directly. — See Chapter 2.1 — Economic Evaluation.

Confounding — A third factor that influences both who receives an intervention and their outcome, creating an association that is not causal. Wikipedia — See Chapter 2.3 — Health Econometrics.

Contract theory — The economics of writing agreements under information asymmetry; its central lesson is that contracts are inevitably incomplete, so what a purchaser can measure and enforce shapes what it actually gets. Wikipedia — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Copayment — A fixed charge the insured pays per service — a set fee per prescription or visit; a form of cost-sharing whose design decides who is deterred. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Cost-and-volume contract — A contract that pays a provider per unit of activity up to an agreed ceiling, sharing demand risk between purchaser and provider. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Cost–benefit analysis (CBA) — An evaluation that values consequences in money, so health gains and costs share units and can be compared with spending outside health. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Cost containment — Measures to hold down health spending; a blunt cap (frozen tariffs, flat budgets) can be a false economy that shifts cost onto households and stores up sicker patients, so the disciplined form removes low-value care rather than squeezing everything equally. — See Chapter 3.1 — Health Systems.

Cost of delay — The health forgone by patients who wait when a valuable intervention is staged or restricted to fit a budget; the price of an affordability constraint. Wikipedia — See Chapter 2.5 — Budget Impact and Affordability.

Cost of poor quality — The failure costs generated by harm, error, and defects in care — extra bed-days, re-treatment, litigation — that a business case for safety seeks to avoid. — See Chapter 3.11 — Quality and Safety Economics.

Cost-per-case contract — A contract that pays a provider for each patient treated, so the provider bears little demand risk but the purchaser's outlay rises directly with activity. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Cost-effectiveness analysis (CEA) — An evaluation that measures outcomes in natural clinical units (e.g. deaths averted) and reports cost per unit of effect. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Cost-effectiveness threshold — The maximum a decision-maker will pay for a unit of health; a contested policy choice, not a law of nature, that varies by country. — See Chapter 2.1 — Economic Evaluation.

Cost-sharing (co-payments) — Charges paid by the user at the point of care that dampen demand for effective and ineffective care alike, hitting the poorest hardest. Wikipedia — See Chapter 1.3 — Market Failure.

Cost-shifting — A decision that saves one budget by loading cost onto another — classically across the health–social-care boundary — with no gain, and often a loss, to the system as a whole. — See Chapter 3.8 — Long-Term and Social Care Economics.

Cost–utility analysis (CUA) — An evaluation that measures outcomes in a common health currency combining length and quality of life, usually the QALY. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Creative destruction — Schumpeter's term for how innovation continually replaces established products and displaces the incumbents who depended on them. Wikipedia — See Chapter 5.1 — Innovation Health Economics.

D

DALY (disability-adjusted life year) — A measure of health loss combining years of life lost with years lived with disability; it underpins Global Burden of Disease and much WHO priority-setting. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Daniels, Norman — The philosopher who, with James Sabin, developed "accountability for reasonableness" as the test of a legitimate priority-setting process. Wikipedia — See Chapter 3.3 — Rationing.

Data governance — The rules for who may hold, use, and profit from health data; an economic lever, because the terms a vendor keeps data on can outweigh the invoice. Wikipedia — See Chapter 5.6 — Health Data Economics.

Data lake — A store of raw data of any shape, kept cheaply now and interpreted later; defers but does not remove the curation cost, and becomes a swamp without funded stewardship. Wikipedia — See Chapter 5.6 — Health Data Economics.

Data mesh — A federated architecture in which each domain owns and publishes its data as a product to common standards; its logic is that context lives with the creators, its risk that every domain must fund real stewardship. Wikipedia — See Chapter 5.6 — Health Data Economics.

Data quality — Completeness, accuracy, timeliness, and consistency, made at the point of care and taxed on every downstream use; an incentive-design problem as much as a technical one. Wikipedia — See Chapter 5.6 — Health Data Economics.

De-identification — Removing or masking identifiers from data; always a spectrum of residual re-identification risk rather than a binary, and never honestly marketed as risk-free. Wikipedia — See Chapter 5.6 — Health Data Economics.

Decision analysis — The formal framework of laying out options, chance events, probabilities, and outcome values, then computing each option's expected value. Wikipedia — See Chapter 2.2 — Modelling.

Decision tree — A branching model from a decision node through chance nodes to outcomes, suited to short, fixed-horizon decisions. Wikipedia — See Chapter 2.2 — Modelling.

Deductible — An amount the insured must pay in full each year before the insurer pays anything; a blunt form of cost-sharing unless capped and targeted. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Default effect — The strong influence of whatever happens when a person does nothing, exploited (for example) by opt-out organ-donation registration. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Deinstitutionalization — The twentieth-century shift from asylums to community mental-health care; a saving where the promised community funding followed the patients, and a cost-shift where it did not. Wikipedia — See Chapter 3.9 — Mental Health Economics.

Dementia — The single largest driver of high-intensity, long-duration long-term-care need, blending cognitive and physical dependency and falling heavily on families. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Dependency ratio — The ratio of dependent (young and old) to working-age people; its shift with ageing populations is a defining fiscal driver of long-term-care cost. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Derived demand — Demand for health care that flows from the deeper demand for health itself; care is an input, not the object of desire. Wikipedia — See Chapter 1.2 — Demand for Health and Healthcare.

Deskilling — The slow erosion of a workforce's competence through reliance on a tool, a cost that only appears when you try to stop using it. Wikipedia — See Chapter 5.3 — AI Health Economics.

Determinants of health — The full set of factors that produce health — genetics and behaviour, medical care, and, dominating at population scale, the social, commercial, and environmental conditions of life; Alan Williams' "box A". Wikipedia — See Chapter 1.5 — Determinants of Health.

Development as Freedom — Sen's book setting out the capability approach for a general audience, reframing development as expanded human freedom rather than income. Wikipedia — See Chapter 3.5 — Capabilities.

Diagnosis-related group (DRG) — A fixed price paid per case according to diagnosis and complexity; rewards efficiency per admission but invites up-coding. Wikipedia — See Chapter 3.1 — Health Systems.

Difference-in-differences — A quasi-experimental design comparing the change in outcomes for an exposed group against an unexposed one, resting on parallel trends. Wikipedia — See Chapter 2.3 — Health Econometrics.

Differential privacy — Adding calibrated statistical noise so that no individual's presence in a dataset can be inferred; buys mathematical privacy guarantees at a price in analytic utility. Wikipedia — See Chapter 5.6 — Health Data Economics.

Diffusion of innovations — How and how fast a proven advance reaches the patients who could benefit, typically following an S-shaped adoption curve. Wikipedia — See Chapter 5.1 — Innovation Health Economics.

Digital divide — Unequal access to devices, connectivity, and the literacy to use them, mapping closely onto the social gradient in health. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Digital health — The umbrella term for using information and communication technologies to support health and care. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Digital literacy — The skills to find, use, and trust digital tools; unequally distributed, so digital-by-default services can exclude those with the greatest need. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Digital therapeutics — Software products that deliver an evidence-based intervention to treat or manage a condition, positioning software itself as the treatment. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Diminishing returns — The falling extra output from adding more of one input while holding the others fixed — a fifth surgeon in a two-theatre unit adds less than the second. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Discounting — Valuing future costs and health at less than the same amount today, a choice that bears heavily on prevention and long-horizon programmes. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Discrete-event simulation — Individual-level modelling that adds queues and timing where patients compete for constrained shared resources such as beds or theatres. Wikipedia — See Chapter 2.2 — Modelling.

Disinvestment — The deliberate withdrawal or reduction of low-value care to release resources for higher-value uses; rationing's neglected other half. — See Chapter 3.3 — Rationing.

Distributional cost-effectiveness analysis — A method that shows how options change both total health and its distribution, letting equity enter the decision rather than a footnote. — See Chapter 3.4 — Equity.

Distributive justice — The theory of how a scarce good ought to be shared — equally, by need, by benefit, or to favour the worst-off — that every rationing rule encodes. Wikipedia — See Chapter 3.4 — Equity.

Division of labour — Splitting a job into tasks assigned to differently-skilled workers; the basis of skill mix and task-shifting in health production. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Doha Declaration — The 2001 WTO declaration affirming that TRIPS should not prevent countries from protecting public health, preserving flexibilities such as compulsory licensing. Wikipedia — See Chapter 4.2 — Global Health and Trade.

Donabedian model — The foundational framework for measuring quality as structure (resources), process (what is done to patients), and outcome (what happens to health). Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

E

Echo chamber — An information environment in which a community mostly encounters beliefs it already holds, so a corrective health message may simply never arrive. Wikipedia — See Chapter 4.4 — Social Media and Health Communication Economics.

Econometrics (health) — The application of statistical methods to health data to measure relationships and, above all, support causal inference. Wikipedia — See Chapter 2.3 — Health Econometrics.

Economic efficiency — Doing the most good with given resources; splits into technical efficiency (fewest inputs) and allocative efficiency (the right output mix). Wikipedia — See Chapter 1.1 — Introduction to Health Economics.

Economic evaluation — The comparison of two or more courses of action by both their costs and their consequences, to make opportunity cost visible. — See Chapter 2.1 — Economic Evaluation.

Economies of scale — Falling average cost as the volume of care produced rises; real in hospitals but modest and exhausted at moderate size. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Economies of scope — Lower cost from producing several services together — shared theatres, laboratories, imaging, and records — the economic case for the general hospital. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Effects of climate change on human health — The rising health burden — heat mortality, shifting infectious disease, worse air quality, event-driven surges — that makes climate a driver of future health cost. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

eHealth — The broad, older term for electronic health services and records. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Early intervention in psychosis — Services that intervene early in psychotic illness to change a lifetime trajectory, a mental-health investment whose returns are real but back-loaded. Wikipedia — See Chapter 3.9 — Mental Health Economics.

Egalitarianism — A distributive view that seeks to equalize health or access across people. Wikipedia — See Chapter 3.4 — Equity.

Environmental determinants of health — The physical environment — air and water quality, the built environment, green space, housing, and neighbourhood safety — as a cause of current health in its own right. — See Chapter 1.5 — Determinants of Health.

EQ-5D — A widely used descriptive instrument (mobility, self-care, usual activities, pain, anxiety/depression) for eliciting the utility weights behind QALYs. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Equity (horizontal and vertical) — Horizontal equity treats equals equally (same need, same care); vertical equity treats unequals appropriately unequally (more for greater need). Wikipedia — See Chapter 3.4 — Equity.

Evergreening — Extending an effective monopoly through new patents on minor reformulations or combinations that add little clinical value. Wikipedia — See Chapter 2.4 — Pharmacoeconomics.

Evidence-based policy — The aspiration that decisions rest on the best available evidence of effect and cost-effectiveness, as one input among values and feasibility. Wikipedia — See Chapter 3.2 — Health Policy.

Evidence Standards Framework — A tiered framework (e.g. NICE's for digital health) setting the proof a tool must show according to its function and financial risk. — See Chapter 5.2 — Digital Health Economics.

Expected utility — Decision theory that weights outcomes by their utility, not merely their money value; because it can weight catastrophic states heavily, it justifies paying more than an actuarially fair premium to avoid ruin. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Expected value — The decision rule that multiplies each outcome by its probability and sums; the workhorse of appraisal, but risk-neutral and so prone to under-counting rare catastrophes. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Experience rating — Setting premiums by an individual's or group's own claims history and risk, so the sick pay more — actuarially precise but corrosive of insurance's protective purpose. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Extra-welfarism — The framework, dominant in modern HTA, that admits outcomes beyond individual utility (most obviously health) and lets the analyst decide what counts. — See Chapter 3.5 — Capabilities.

External reference pricing — Setting or capping a domestic price by reference to a basket of other countries' prices; cheap but prone to launch-high and launch-delay responses. Wikipedia — See Chapter 2.4 — Pharmacoeconomics.

Externality — A cost or benefit that falls on someone outside a transaction, such as the protection vaccination gives the unvaccinated. Wikipedia — See Chapter 1.3 — Market Failure.

F

FAIR data — The stewardship standard that data be findable, accessible, interoperable, and reusable; the test of whether a dataset is an asset or an archive. Wikipedia — See Chapter 5.6 — Health Data Economics.

Fair innings argument — Alan Williams' claim that everyone is entitled to a normal lifetime span of health, giving the young sick a stronger claim than the old sick and justifying age weighting. — See Chapter 3.4 — Equity.

Fast Healthcare Interoperability Resources (FHIR) — The dominant open standard for exchanging health data between systems, maintained by HL7 International; requiring it at purchase lowers integration costs and weakens vendor lock-in. Wikipedia — See Chapter 5.4 — Software Engineering Health Economics.

Federated learning — Training models across distributed datasets without pooling the records, shifting the privacy–utility frontier outward for multi-site health data. Wikipedia — See Chapter 5.6 — Health Data Economics.

Fee-for-service — Paying for each item of activity, which rewards volume and invites supplier-induced demand. Wikipedia — See Chapter 3.1 — Health Systems.

Financial headroom — The space a budget holder actually has to absorb new spending after existing commitments — almost always far smaller than the total budget. — See Chapter 2.5 — Budget Impact and Affordability.

Fiscal space — The room a government has to raise health spending without endangering the sustainability of the public finances; WHO names growth, re-prioritization, earmarked taxes, aid, and efficiency as its sources, each with a ceiling. Wikipedia — See Chapter 3.1 — Health Systems.

Fixed cost — A cost that does not vary with the number of patients in the short run (the building, the core establishment, the scanner). Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Forest plot — The canonical display of a meta-analysis: each study a horizontal line showing its estimate and confidence interval, the pooled result a diamond at the foot. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

Framework Convention on Tobacco Control — The WHO treaty that holds a line against tobacco-industry pressure no single government could hold alone. Wikipedia — See Chapter 3.2 — Health Policy.

Framing — The way a logically identical fact changes behaviour depending on how it is presented (e.g. survival versus mortality). Wikipedia — See Chapter 4.1 — Behavioural Economics.

Fundamental cause theory — Link and Phelan's explanation of why the tie between social position and health persists as diseases change: higher-status people command flexible resources they can deploy against whatever threatens health in any era. Wikipedia — See Chapter 1.5 — Determinants of Health.

Funnel plot — A scatter plot of study effect against precision, whose asymmetry is used to screen for publication bias and missing small negative studies. — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

G

Gavi — A vaccine alliance that subsidizes immunization and shapes markets with tools such as advance market commitments and co-financing requirements. Wikipedia — See Chapter 4.2 — Global Health and Trade.

Generic drug — A chemically identical copy of a small-molecule medicine, marketable once patents lapse; entry typically collapses price towards manufacturing cost. Wikipedia — See Chapter 2.4 — Pharmacoeconomics.

Gini coefficient — A single-number summary of income inequality, conceptually the same family of tool as the concentration index. Wikipedia — See Chapter 3.4 — Equity.

Global catastrophic risk — A class of events that could inflict damage on a planetary scale; preparedness shares their appraisal difficulty — contested probabilities, vast consequences, and the danger of waiting for proof. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Global Fund — A disease-specific vertical fund financing responses to AIDS, tuberculosis, and malaria worldwide. Wikipedia — See Chapter 4.2 — Global Health and Trade.

Global health — The study and practice of health where threats, remedies, and money cross national borders. Wikipedia — See Chapter 4.2 — Global Health and Trade.

Global mental health — The field addressing the vast treatment gap for mental disorders in low- and middle-income settings, often through task-sharing to non-specialists. Wikipedia — See Chapter 3.9 — Mental Health Economics.

Global public good — A good that is non-rival and non-excludable across borders (e.g. disease surveillance), chronically under-supplied without collective financing. Wikipedia — See Chapter 4.2 — Global Health and Trade.

GRADE — The Grading of Recommendations Assessment, Development and Evaluation approach, which rates the certainty of evidence for each outcome as high, moderate, low, or very low. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

Greenhouse gas — A gas such as carbon dioxide that traps heat in the atmosphere; health-service emissions are measured in carbon-dioxide equivalent. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Grey literature — Theses, reports, conference abstracts, and unpublished data outside the journal literature, searched in a systematic review to counter publication bias. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

Grossman model — Michael Grossman's 1972 framing of health as a durable capital stock that depreciates with age and is renewed by investment, wanted for both consumption and investment. Wikipedia — See Chapter 1.2 — Demand for Health and Healthcare.

H

Headroom analysis — An early-HTA method asking, before much is spent, what a technology would have to achieve and cost to be worth adopting at all. — See Chapter 5.1 — Innovation Health Economics.

Health care quality — The multidimensional idea that good care is safe, effective, patient-centred, timely, efficient, and equitable — no single number captures it, which is why measurement is contested. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

Health care rationing — The allocation of scarce care among competing claims; the discipline of making the invisible loss visible and saying no fairly. Wikipedia — See Chapter 3.3 — Rationing.

Health communication — Conveying information that improves health decisions — campaigns, patient information, outreach; economically a form of prevention whose benefits are counterfactual and therefore chronically undervalued at budget time. Wikipedia — See Chapter 4.4 — Social Media and Health Communication Economics.

Health economics — The disciplined study of how societies use limited resources to produce and distribute health, making trade-offs explicit. Wikipedia — See Chapter 1.1 — Introduction to Health Economics.

Health equity — The absence of unfair and avoidable differences in health and in access to health care. Wikipedia — See Chapter 3.4 — Equity.

Health human resources — The planning and stock of the health workforce, treated as an interacting system of substitutes and complements. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Health impact assessment — A structured appraisal of the health consequences of a policy or development, used to bring health (and climate) into wider decisions. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Health in All Policies — An approach that embeds health impact into decisions made outside the health sector — housing, transport, planning, education, fiscal policy — because that is often the cheapest place to prevent ill health. Wikipedia — See Chapter 1.5 — Determinants of Health.

Health insurance — The trade of a small certain premium for protection against a large uncertain loss; a rational demand for financial protection in every system. Wikipedia — See Chapter 1.2 — Demand for Health and Healthcare.

Health literacy — The capacity to obtain, understand, and use health information; unevenly distributed, correlated with disadvantage, and a design constraint on every public health message. Wikipedia — See Chapter 4.4 — Social Media and Health Communication Economics.

Health maintenance organization (HMO) — A managed-care organization that combines insurance and provision and channels members to a defined network of providers. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Health policy — The decisions, plans, and actions a government takes to pursue population-health goals and correct market failures. Wikipedia — See Chapter 3.2 — Health Policy.

Health system — The whole set of organizations, people, and resources whose primary purpose is to promote, restore, or maintain health. Wikipedia — See Chapter 3.1 — Health Systems.

Health technology assessment (HTA) — The systematic appraisal of a technology's costs, benefits, and consequences, run by bodies such as NICE and IQWiG to inform coverage and pricing. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Healthcare-associated infection — An infection acquired during care rather than present on admission (bloodstream, urinary, surgical-site); the archetypal measurable, costly, and partly preventable harm. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

Hepatitis C — The curative direct-acting antiviral for chronic hepatitis C is the canonical case of a highly cost-effective treatment whose aggregate budget impact forced staged access. Wikipedia — See Chapter 2.5 — Budget Impact and Affordability.

Hierarchy of evidence — The ranking of study designs by their risk of bias, from systematic reviews of trials at the top to expert opinion at the base; a rule of thumb about design, not a guarantee. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

High-risk strategy (prevention) — Concentrating preventive effort on the minority at greatest risk; favourable benefit-to-cost per person but limited reach across total cases. — See Chapter 3.2 — Health Policy.

Human capital — A stock, like education or skills, that yields returns over many years; the Grossman model treats health as one form of it. Wikipedia — See Chapter 1.2 — Demand for Health and Healthcare.

Human capital flight — The migration of publicly trained clinicians from poorer to richer systems, often called the medical "brain drain". Wikipedia — See Chapter 4.2 — Global Health and Trade.

Human Development Index — A measure that values development as expanded human freedom rather than income alone, rooted in the capability approach. Wikipedia — See Chapter 3.5 — Capabilities.

I

Iatrogenesis — Harm caused by medical care itself rather than by the underlying disease. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

ICECAP measures — Instruments (ICECAP-O for older people, ICECAP-A for adults) that measure capability — attributes such as attachment, security, and control — rather than health. — See Chapter 3.5 — Capabilities.

ICER (incremental cost-effectiveness ratio) — The difference in cost between two options divided by the difference in effect, judged against a threshold. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Improving Access to Psychological Therapies (NHS Talking Therapies) — England's large-scale programme delivering evidence-based psychological treatment, partly justified on the economics of restored employment. Wikipedia — See Chapter 3.9 — Mental Health Economics.

Income elasticity of demand — The responsiveness of health-care use, or national health spending, to changes in income. Wikipedia — See Chapter 1.2 — Demand for Health and Healthcare.

Inducement prize contest — A fixed reward for achieving a defined goal that, in its pure form, places the resulting knowledge in the public domain. Wikipedia — See Chapter 5.1 — Innovation Health Economics.

Infodemic — The WHO's term for an overabundance of information, accurate and not, during an emergency, which makes trustworthy guidance hard to find exactly when it matters most. Wikipedia — See Chapter 4.4 — Social Media and Health Communication Economics.

Informal care — Unpaid support provided by family and friends, often the largest single input in the long-term-care system and routinely valued at zero in accounts. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Information asymmetry — The gap in knowledge between the two sides of a health transaction, which turns the clinical relationship into an agency problem. Wikipedia — See Chapter 1.3 — Market Failure.

Instrumental variables — An estimation method using a variable that affects who gets treated but does not otherwise affect the outcome, to isolate variation free of confounding. Wikipedia — See Chapter 2.3 — Health Econometrics.

Integrated care — Knitting providers together so that a single accountable entity manages a whole pathway, an alternative to buying fragmented services piecemeal. Wikipedia — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Integration (health and social care) — Pooling budgets, aligning assessment, and organizing services around the person to overcome cost-shifting at the health–social-care boundary; better coordination rather than quick savings. — See Chapter 3.8 — Long-Term and Social Care Economics.

Intention-to-treat analysis — Analysing trial participants in the group they were randomized to, to stop selection bias creeping back in. Wikipedia — See Chapter 2.3 — Health Econometrics.

Interoperability — The ability of systems to exchange information and use what is exchanged; chronically under-supplied by markets because its benefits are network-wide while its costs fall on each vendor and buyer. Wikipedia — See Chapter 5.4 — Software Engineering Health Economics.

Inverse care law — Tudor Hart's observation that the availability of good medical care tends to vary inversely with the need of the population served. Wikipedia — See Chapter 3.4 — Equity.

J

K

Kakwani index — A measure of the progressivity of health financing, given by the gap between how payments are distributed and how income is distributed. — See Chapter 3.4 — Equity.

Kremer, Michael — The economist who, with colleagues, developed the advance market commitment to pull private research towards diseases of poorer countries. Wikipedia — See Chapter 5.1 — Innovation Health Economics.

L

Labour economics — The study of how wages and employment are set by workers supplying effort and employers demanding it; the frame for the health workforce as a market. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Learning curve — The improvement of outcomes and speed with operator and team experience; makes early adoption a real cost, mature-centre results non-transferable, and concentration of volumes economically attractive. Wikipedia — See Chapter 5.5 — Robotics Health Economics.

Legacy system — Software kept in service past the point where it can be economically maintained, because it works and replacement is frightening; technical debt at organizational scale. Wikipedia — See Chapter 5.4 — Software Engineering Health Economics.

Libertarian paternalism — Thaler and Sunstein's justification for nudging: arrange the unavoidable choice architecture to help people achieve their own goals while preserving free choice. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Life-course approach — The view that health exposures accumulate and that critical periods, especially the first thousand days, cast decade-long shadows — creating lag structures that short-horizon return-on-investment tools undervalue. Wikipedia — See Chapter 1.5 — Determinants of Health.

Life-cycle assessment — Tracing emissions from raw material through manufacture, use, and disposal; the method needed to measure a health system's dominant supply-chain footprint. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Living review — A systematic review kept continuously up to date as new studies appear, so guidance never drifts years behind the science; reserved for high-stakes, fast-moving questions. — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

Long-term care — Support, often for years, for people whose functional capacity has declined through age, disability, frailty, or chronic illness; a state to be sustained rather than an illness resolved. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Long-term care insurance — Cover intended to pool the risk of needing years of expensive care; a market that has failed almost everywhere through adverse selection, long-horizon uncertainty, and myopia. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Loss aversion — The tendency to weigh losses more heavily than equivalent gains, a central plank of prospect theory. Wikipedia — See Chapter 4.1 — Behavioural Economics.

M

Machine learning — The building of models trained on data rather than explicitly programmed, the basis of most consequential health AI. Wikipedia — See Chapter 5.3 — AI Health Economics.

Major depressive disorder — A common mental disorder that, through absenteeism and especially presenteeism, drives large productivity loss that health-system-only evaluation cannot see. Wikipedia — See Chapter 3.9 — Mental Health Economics.

Make-or-buy decision — The purchaser's choice whether to commission a service from an external provider, deliver it in-house, or integrate providers around a pathway. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Managed care — Techniques — networks, gatekeeping, utilization management, prior authorization — by which an insurer actively influences the care members receive, a response to moral hazard. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Managed entry agreement — A contract granting access to a medicine on conditions — a confidential discount, a spend cap, a refund, or coverage while data are collected. — See Chapter 2.4 — Pharmacoeconomics.

Mapping (cross-walking) — A statistical function that predicts generic utility values from a condition-specific measure, so QALYs can be recovered — a useful bridge that adds a layer of uncertainty. — See Chapter 2.1 — Economic Evaluation.

Marginal cost — The cost of producing one more case; often well below average cost in a hospital, which quietly shapes every pricing and volume decision. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Marginalism (marginal analysis) — Judging value at the margin — whether the next unit is worth more than the same resources spent elsewhere — rather than all-or-nothing. Wikipedia — See Chapter 1.1 — Introduction to Health Economics.

Market failure — Any situation in which a market, left to itself, allocates resources inefficiently; health care is the textbook case. Wikipedia — See Chapter 1.3 — Market Failure.

Market structure — How providers compete — from monopolistic competition to oligopoly to natural monopoly — which shapes how supply is organized. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Markov model — A model representing a disease as mutually exclusive health states with cohorts moving between them in fixed cycles; the workhorse for chronic disease. Wikipedia — See Chapter 2.2 — Modelling.

Marmot, Michael — The epidemiologist whose Whitehall studies established the social gradient in health and who has led its translation into policy. Wikipedia — See Chapter 1.5 — Determinants of Health.

Means test — An eligibility test based on assets and income, used in safety-net long-term-care systems; concentrates public money on the poorest but creates a hard cliff-edge. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Medical education — The long, expensive, partly publicly funded training of clinicians; a human-capital investment with decade-long lags that set future supply. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Medical error — A preventable adverse event caused by a mistake in care; the structured response is root cause analysis of the system, not blame of the individual. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

Medical software — Software intended for a medical purpose, which the FDA and others term "software as a medical device". Wikipedia — See Chapter 5.3 — AI Health Economics.

Medical tourism — Patients travelling across borders for treatment, whether for price, speed, or procedures unavailable at home; trade in health services. Wikipedia — See Chapter 4.2 — Global Health and Trade.

Mental disorder — A condition affecting thinking, mood, or behaviour; mental disorders carry a share of disease burden far larger than their share of most health budgets. Wikipedia — See Chapter 3.9 — Mental Health Economics.

Mental health parity — The legal or policy principle that mental health be valued, resourced, and treated on equal terms with physical health. Wikipedia — See Chapter 3.9 — Mental Health Economics.

Meta-analysis — The statistical pooling of results from several studies into a single combined estimate, legitimate only when the studies are similar enough to combine. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

mHealth — Health services delivered through mobile devices — smartphones, tablets, and the apps and messaging that run on them. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Microsimulation — Individual-level modelling that runs patients through one at a time, preserving heterogeneity and event history. Wikipedia — See Chapter 2.2 — Modelling.

Misinformation (health) — False health information understood economically as a negative externality of the attention market: the producer captures engagement while the costs land on patients and health systems. Wikipedia — See Chapter 4.4 — Social Media and Health Communication Economics.

Missing data — Incomplete records whose very absence is often related to the outcome, so discarding them quietly reintroduces selection bias. Wikipedia — See Chapter 2.3 — Health Econometrics.

Monopsony — A market with a single dominant employer, which can set wages below the competitive level; the signature is a persistent vacancy the employer will not clear by raising pay. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Monte Carlo method — Repeated random sampling used in probabilistic sensitivity analysis to propagate all parameter uncertainty through a model. Wikipedia — See Chapter 2.2 — Modelling.

Moral hazard — The change in behaviour once insured, whereby patients and providers use more care because someone else pays at the point of use. Wikipedia — See Chapter 1.3 — Market Failure.

N

National Institute for Health and Care Excellence (NICE) — England's HTA body, an exemplar of a published reference case, perspective, and cost-per-QALY threshold. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Natural experiment — A situation where something outside participants' control mimics random allocation, lending credibility to observational analysis. Wikipedia — See Chapter 2.3 — Health Econometrics.

Natural monopoly — A market where scale economies and limited demand make a single provider efficient, so competition cannot discipline price or quality and regulation must. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Net zero emissions — A state in which emissions are balanced by removals; the target framing for decarbonizing a health system, credible only with a dated trajectory. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Network effect — The way a platform grows more valuable as more people use it, which can entrench a single vendor and raise long-run cost. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Network meta-analysis — A synthesis that combines direct and indirect evidence across a connected network of treatments to estimate comparisons never studied head-to-head; indispensable for HTA. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

Never event — A serious, largely preventable safety incident — wrong-site surgery, a retained instrument — that should never occur if defined safeguards are followed, and which many payers refuse to fund. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

Nudge — Any feature of choice architecture that predictably alters behaviour without forbidding options or significantly changing incentives, and that is easy to avoid. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Nurse practitioner — An advanced-practice nurse who can take on work once reserved to doctors; a common vehicle for task-shifting when done with training and supervision. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Nussbaum, Martha — The philosopher who extended Sen's capability approach into a list of central human capabilities. Wikipedia — See Chapter 3.5 — Capabilities.

O

Occupational burnout — Exhaustion and disengagement from chronic workplace stress; an economic variable that raises turnover, absence, and error and lowers effective labour supply. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Occupational licensing — Making it illegal to practise without a state-recognized credential; protects patients but restricts entry and raises insider incomes. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

One Health — The framing that links human, animal, and environmental health, important for emerging infectious disease. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Open-source software — Software whose source code is freely usable and modifiable; not free — implementation, hosting, and stewardship remain — but it removes the lock-in premium and lets many buyers co-fund a common good. Wikipedia — See Chapter 5.4 — Software Engineering Health Economics.

Opportunity cost — The value of the best alternative a decision displaces; in a fixed budget, the true price of everything. Wikipedia — See Chapter 1.1 — Introduction to Health Economics.

Option value (of preparedness) — The worth of keeping a future course of action open under uncertainty; preparedness is a portfolio of such options — each stockpile or platform a call option on a rapid response. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Oregon Health Plan — The canonical attempt at fully explicit rationing, ranking condition–treatment pairs and drawing a funding line. Wikipedia — See Chapter 3.3 — Rationing.

Orphan drug — A medicine for a rare disease, where small patient numbers cannot spread development costs, sharpening the pricing problem. Wikipedia — See Chapter 2.4 — Pharmacoeconomics.

Out-of-pocket maximum — An annual ceiling on an insured person's own payments, beyond which the insurer pays everything; the design element that guarantees a policy still insures the sickest. — See Chapter 3.7 — Insurance and Risk Protection.

Out-of-pocket payment — Cash paid at the point of care where pooling is thin; offers none of the protection a pooled system gives. Wikipedia — See Chapter 3.1 — Health Systems.

Outcome-based contract — A contract that makes some or all payment contingent on results achieved rather than activity delivered; a social impact bond is one financing wrapper. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Outsourcing — Buying a service from an external provider rather than delivering it in-house; the "buy" side of the make-or-buy decision. Wikipedia — See Chapter 3.10 — Strategic Purchasing and Commissioning.

P

Pandemic prevention — Measures to reduce the likelihood and impact of pandemics, from surveillance and pathogen genomics to standing response capacity — largely public goods that markets and annual budgets under-provide. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Panel data — Repeated observations of the same units over time, allowing the analyst to control for everything stable about a unit. Wikipedia — See Chapter 2.3 — Health Econometrics.

Panic-and-neglect cycle — The recurring pattern of lavish spending during an emergency followed by under-investment once the threat recedes, which leaves preparedness chronically depleted between crises. — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Parity of esteem — The principle that mental health be resourced and treated on equal terms with physical health, set against chronic under-funding relative to burden. — See Chapter 3.9 — Mental Health Economics.

Passive purchasing — Paying for whatever providers deliver, without actively choosing what to buy, from whom, or how — the foil to strategic purchasing. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Patent — A time-limited monopoly that lets an inventor charge above cost to recoup investment, trading dynamic incentive against static access. Wikipedia — See Chapter 5.1 — Innovation Health Economics.

Patient safety — Freedom from preventable harm during health care; the goal that the economics of quality and safety serves. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

Patient-reported outcome measures (PROMs) — Standardized questionnaires patients complete about their own symptoms, functioning, and quality of life; increasingly the raw material from which outcome values and QALYs are built. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Patient values versus public values — The contested question of whose preferences should set health-state weights: the public who fund the system but have not lived the state, or the patients who have adapted to it. — See Chapter 3.5 — Capabilities.

Pay-for-performance — Tying a portion of provider payment to measured quality or safety; effective against clear underuse but exposed to Goodhart's law and gaming. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

Pharmacoeconomics — The branch of health economics studying the costs and consequences of pharmaceutical products and the systems that pay for them. Wikipedia — See Chapter 2.4 — Pharmacoeconomics.

Phased (managed) adoption — Introducing a valuable but unaffordable intervention in stages — prioritizing the highest-need first, capping volumes, or spreading the cash — to fund something real within available headroom. — See Chapter 2.5 — Budget Impact and Affordability.

Physician supply — The stock of doctors, set by a training pipeline whose long lags mean today's intake decisions determine supply a decade hence. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Pigovian tax — A tax set equal to the external cost a behaviour imposes on others, making the private price reflect the social cost. Wikipedia — See Chapter 3.2 — Health Policy.

Planetary health — The framing that human health depends on the health of natural systems, so degrading them degrades health. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Plumbing diagram — Alan Williams' schematic dividing health economics into eight interconnected boxes, from determinants of health to planning. Wikipedia — See Chapter 1.1 — Introduction to Health Economics.

Population health — The health of a whole group, and its distribution, taken as the unit of concern rather than the individual patient. Wikipedia — See Chapter 1.5 — Determinants of Health.

Population strategy (prevention) — Shifting the whole population's risk distribution slightly (a tax, a reformulation target, a default) to prevent many cases in aggregate, with small individual benefit. — See Chapter 3.2 — Health Policy.

Precautionary principle — The rule that, where a threat is potentially irreversible and catastrophic, protective action is warranted even under deep uncertainty about its probability — shifting the burden of proof, not licensing unlimited spend. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Precision medicine (stratified / personalized medicine) — Using biological information, often genomic, to target a therapy at the subgroup likely to benefit rather than treating an average patient. — See Chapter 5.1 — Innovation Health Economics.

Preferred provider organization (PPO) — A managed-care arrangement offering wider provider choice at higher cost than an HMO. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Present bias — The systematic over-weighting of the present against the future, the behavioural mechanism behind chronic under-investment in prevention. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Presenteeism — The productivity lost when people are present at work but impaired by illness; in mental illness usually the larger part of the productivity loss. Wikipedia — See Chapter 3.9 — Mental Health Economics.

Prevention (primary, secondary, tertiary) — The three levels of prevention — stopping disease arising; detecting and treating it early; limiting the damage of established disease — each with a distinct economics. — See Chapter 3.2 — Health Policy.

Prevention paradox — A preventive measure that brings large benefit to a population may offer little to each participating individual (Geoffrey Rose). — See Chapter 3.2 — Health Policy.

Preventive healthcare — Action to avert illness before it occurs; not automatically cheaper than cure, and to be appraised like any treatment. Wikipedia — See Chapter 3.2 — Health Policy.

Price discrimination — Charging different buyers different prices for the same product; pharmaceutical markets are a textbook case. Wikipedia — See Chapter 2.4 — Pharmacoeconomics.

Price elasticity of demand — The percentage change in the quantity of care used for a percentage change in the price the user faces. Wikipedia — See Chapter 1.2 — Demand for Health and Healthcare.

Prior authorization — A managed-care tool requiring an insurer's approval before certain expensive services are delivered; useful against overuse, corrosive when it rations by hassle. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Prioritarianism — A distributive-justice view that seeks more health overall but gives extra moral weight to gains for the worse-off; the ethical basis of equity weights. Wikipedia — See Chapter 3.4 — Equity.

PRISMA — The Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the reporting standard that documents every step from search to synthesis so a reader can check what was done. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

Procedural justice — Fairness in how a decision is made; the source of legitimacy when people cannot agree on the right outcome. Wikipedia — See Chapter 3.3 — Rationing.

Procurement — The process of competitively selecting and awarding contracts fairly and transparently; in the public sector its regulated form is public procurement. Wikipedia — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Production function — The relationship between the inputs a provider uses — labour, capital, consumables, technology — and the health services it produces. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Programme budgeting — A discipline (with marginal analysis) for comparing what an extra unit of resource buys across competing uses, making disinvestment systematic. Wikipedia — See Chapter 3.3 — Rationing.

Progressive tax — A financing system in which the rich contribute a larger share of income than the poor; its opposite is regressive. Wikipedia — See Chapter 3.4 — Equity.

Proportionate universalism — Acting universally but with intensity scaled to need, so a programme captures the whole social gradient rather than only the worst-off tail. — See Chapter 1.5 — Determinants of Health.

Public good (economics) — A good that is non-rival and non-excludable (e.g. disease surveillance, research knowledge), under-produced by an unaided market. Wikipedia — See Chapter 1.3 — Market Failure.

Public health — The organized effort to protect and improve the health of populations, supplying much of policy's rationale. Wikipedia — See Chapter 3.2 — Health Policy.

Public-health return on investment (ROI) tools — Practitioner calculators (e.g. GOV.UK / Public Health England) that estimate a prevention programme's payback over realistic multi-year horizons and by population group. — See Chapter 3.2 — Health Policy.

Public procurement — The regulated public form of procurement, bound by rules of fairness, transparency, and competition when a public body buys services. Wikipedia — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Publication bias — The tendency for positive, significant studies to be published and negative ones to remain unpublished, so the visible literature overstates effects; screened for with a funnel plot. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

Purchaser–provider split — The structural separation between the body that holds the money and buys care and the bodies that deliver it — what makes strategic purchasing a distinct discipline. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Push and pull mechanisms — Push funding pays for research inputs before success (grants, tax credits); pull funding rewards outputs after success (patents, prizes, AMCs). — See Chapter 5.1 — Innovation Health Economics.

Q

QALY (quality-adjusted life year) — A generic measure weighting years of life by a health-related quality score (full health 1.0, death 0), enabling comparison across conditions. Wikipedia — See Chapter 2.1 — Economic Evaluation.

R

RAND Health Insurance Experiment — The landmark randomized study showing cost-sharing reduces care used, mostly without average harm but with harm to the poorest and sickest. Wikipedia — See Chapter 1.3 — Market Failure.

Random-effects model — A meta-analysis model that assumes the true effect genuinely varies across studies and estimates the average of that distribution, giving wider, more honest uncertainty than a fixed-effect model. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

Randomized controlled trial (RCT) — A study allocating participants to treatment or control by chance, balancing known and unknown confounders. Wikipedia — See Chapter 2.3 — Health Econometrics.

Rationing — The allocation of a scarce resource among competing claims; in health, a permanent condition to be managed openly and fairly. Wikipedia — See Chapter 3.3 — Rationing.

Rawlsian maximin ("just health") — The view (John Rawls, extended by Norman Daniels) that prioritizes the worst-off and grounds a right to health care in fair equality of opportunity. — See Chapter 3.4 — Equity.

Real option — An asset whose worth lies in the flexibility to act if circumstances demand it; preparedness — stockpiles, surge capacity, standing platforms — is valued this way, not by conventional net-present-value arithmetic. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Regression discontinuity design — A quasi-experimental method exploiting a sharp eligibility threshold to compare near-identical people just above and below the line. Wikipedia — See Chapter 2.3 — Health Econometrics.

Regulation — Rules that mandate or prohibit, from licensing and safety standards to advertising bans, a heavier point on the coercion spectrum. Wikipedia — See Chapter 3.2 — Health Policy.

Regulatory capture — The tendency for the industries a regulator oversees to shape its rules in their own favour. Wikipedia — See Chapter 3.2 — Health Policy.

Reinsurance — Insurance for insurers, by which a scheme covers itself against extreme individual claims, stabilizing a pool without narrowing coverage. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Remote patient monitoring — Using devices such as blood-pressure cuffs and glucose sensors to collect data outside a clinical setting and route it to a care team. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Research and development (R&D) — The production of new knowledge and its translation into usable products, running from basic science through development. Wikipedia — See Chapter 5.1 — Innovation Health Economics.

Response shift — Changes in a person's internal standards, values, or conception of quality of life over time; closely tied to adaptation. — See Chapter 3.5 — Capabilities.

Returns to scale — How output responds when all inputs are scaled together — rising more than, in step with, or less than proportionately. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Return on investment (ROI / SROI) — The ratio of monetized benefit to cost used in public-health business cases; SROI widens the lens to social and wellbeing value. — See Chapter 2.1 — Economic Evaluation.

Risk equalization — Transferring funds towards payers that enrol sicker members, so competition between insurers is about efficiency rather than risk-selection. Wikipedia — See Chapter 3.1 — Health Systems.

Risk pool — A group large and mixed enough that the healthy majority cover the sick minority, so predictable contributions can finance the group's cost. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Robot-assisted surgery — Surgery performed with a surgeon at a console controlling robotic instruments; its economics are procedure-specific, capital-intensive, and dominated by utilization, consumables, and the learning curve. Wikipedia — See Chapter 5.5 — Robotics Health Economics.

Root cause analysis — The structured investigation after a serious incident that looks past the individual to the system failures behind it, so fixing a cause prevents a class of future harms. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

Rule of Rescue — The pull to overspend on a visible, identifiable patient in peril while the larger statistical population loses out unseen. Wikipedia — See Chapter 3.3 — Rationing.

S

Scarcity — The permanent condition that resources are insufficient to satisfy all the wants that could claim them; the starting axiom of the field. Wikipedia — See Chapter 1.1 — Introduction to Health Economics.

Scope of practice — The rules defining what each licensed profession is legally permitted to do; where they are drawn decides who may safely and lawfully perform a task. Wikipedia — See Chapter 3.6 — Health Workforce and Labour Markets.

Selection bias — Bias arising when the people in the treated and comparison groups were sorted by a process itself related to the outcome. Wikipedia — See Chapter 2.3 — Health Econometrics.

Selective contracting — Narrowing the provider network to those meeting quality, volume, or price standards rather than paying any willing provider; the engine of managed care. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Sen, Amartya — Economist and philosopher who developed the capability approach, reframing wellbeing around what people are able to be and do. Wikipedia — See Chapter 3.5 — Capabilities.

Sensitivity analysis — Testing how a model's conclusion moves when its inputs change, deterministically or probabilistically. Wikipedia — See Chapter 2.2 — Modelling.

Sin tax — The political name for a consumption tax on tobacco, alcohol, or sugar, partly correcting externalities and internalities and partly raising revenue. Wikipedia — See Chapter 3.2 — Health Policy.

Single-payer healthcare — A system in which one public payer funds care for the whole population, the archetype of the Beveridge model. Wikipedia — See Chapter 3.1 — Health Systems.

Site reliability engineering — The discipline of managing software reliability against explicit availability targets, budgeting for acceptable failure; economically, insurance whose premium is engineering effort. Wikipedia — See Chapter 5.4 — Software Engineering Health Economics.

Skill mix and task-shifting — The balance of staff types on a team, and the moving of a task from a higher-cost professional to a lower-cost, appropriately-trained one. — See Chapter 3.6 — Health Workforce and Labour Markets.

Social care — Personal and practical support with daily living, as distinct from medical treatment, though the two constantly overlap. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Social cost of carbon — The estimated economic damage, including health damage, from emitting one additional tonne of carbon dioxide; used to monetize a footprint in appraisal. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Social determinants of health — The conditions of daily life — income, education, employment, housing, food, early-childhood experience — together with the structural drivers that shape them; for a population, the principal production inputs of health. Wikipedia — See Chapter 1.5 — Determinants of Health.

Social gradient in health — The finding that health improves stepwise as social position rises across the entire range, not only at the bottom — the field's most robust result, shown by the Whitehall studies. — See Chapter 1.5 — Determinants of Health.

Social impact bond — A financing wrapper for outcome-based contracts in which investors fund a service and are repaid only if agreed outcomes are achieved, bearing the risk of shortfall. Wikipedia — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Social insurance — Mandatory contributory pooling of a risk, the model behind statutory long-term-care insurance in Germany and Japan. Wikipedia — See Chapter 3.8 — Long-Term and Social Care Economics.

Social marketing — Applying commercial marketing methods — segmentation, message testing, channel strategy — to behaviour that benefits the audience and society rather than a seller. Wikipedia — See Chapter 4.4 — Social Media and Health Communication Economics.

Software maintenance — Corrective, adaptive, and preventive work on software in service; commonly the majority of a system's lifetime cost, and the reason the purchase price is never the economic unit of analysis. Wikipedia — See Chapter 5.4 — Software Engineering Health Economics.

Strategic purchasing — The deliberate, evidence-based use of a payer's buying power to decide what services to buy, from whom, and how — the active alternative to passively paying for whatever is delivered. — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Subjective well-being — How people rate their own lives; a tradition distinct from capability, which measures what people are free to do rather than how they feel. Wikipedia — See Chapter 3.5 — Capabilities.

Sufficientarianism — The view that justice requires everyone to reach a threshold of "enough" health or access, after which residual inequality is less pressing. — See Chapter 3.4 — Equity.

Sugary drink tax — A levy on sugar-sweetened beverages, most effective when tiered on sugar content so it also rewards reformulation. Wikipedia — See Chapter 3.2 — Health Policy.

Sunstein, Cass — Co-author, with Richard Thaler, of the nudge and libertarian-paternalism framework. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Supplier-induced demand — Care generated by the provider's interest rather than the patient's need, opened up by imperfect agency. Wikipedia — See Chapter 1.3 — Market Failure.

Surge capacity — A health system's ability to expand rapidly beyond normal capacity in an emergency — beds, staff, ventilators, laboratory throughput; deliberately slack capacity justified on option-value rather than utilization grounds. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Sustainable healthcare — Care delivered so as to decarbonize estates, supply chains, and models toward net zero while remaining clinically effective. Wikipedia — See Chapter 4.3 — Climate and Planetary Health Economics.

Systematic review — A structured method for locating, appraising, and summarizing all the studies bearing on a question, using a pre-registered protocol so it is reproducible and resistant to bias. Wikipedia — See Chapter 2.6 — Evidence Synthesis and Meta-Analysis.

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Tail risk — The risk of extreme, low-frequency, high-consequence events in the tail of the loss distribution, exactly where ordinary intuition and expected-value appraisal fail. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Technical debt — The implied future cost of choosing an expedient software design now instead of a sound one; it accrues interest as every later change costs more, and unmanaged debt compounds into an unbooked liability. Wikipedia — See Chapter 5.4 — Software Engineering Health Economics.

Telehealth — The delivery of care and health information at a distance, with telemedicine reserved for remote clinical services such as a video consultation. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Thaler, Richard — Economist who, with Cass Sunstein, popularised nudge theory and choice architecture. Wikipedia — See Chapter 4.1 — Behavioural Economics.

Time preference — How heavily a person discounts the future, shaping how much they invest today in prevention and health. Wikipedia — See Chapter 1.2 — Demand for Health and Healthcare.

Time trade-off — A preference-elicitation method for valuing health states, used to derive the utility weights behind QALYs. Wikipedia — See Chapter 2.1 — Economic Evaluation.

Total cost of ownership — The full cost of a system over its life — acquisition, integration, data migration, training, hosting, support, upgrades, security, and decommissioning — the correct economic unit for any software decision. Wikipedia — See Chapter 5.4 — Software Engineering Health Economics.

Treatment gap — The proportion of people with a disorder who receive no treatment, or none adequate; large everywhere and enormous in low- and middle-income countries. — See Chapter 3.9 — Mental Health Economics.

TRIPS Agreement — The WTO agreement obliging members to grant pharmaceutical patents, which raises prices above marginal cost. Wikipedia — See Chapter 4.2 — Global Health and Trade.

Trusted research environment — A secure enclave where vetted analysts come to the data and only checked results leave; dominates dataset shipping on both risk and auditability. — See Chapter 5.6 — Health Data Economics.

Two-tier healthcare — A system in which private cover buys faster or better access to services the public system also provides, with equity consequences. Wikipedia — See Chapter 3.1 — Health Systems.

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Underwriting — The insurer's assessment and pricing of the risk it is asked to cover; its consequences at the point of care are what design must serve. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Universal health care — Coverage for everyone who needs care, with financial protection so that using it does not cause hardship. Wikipedia — See Chapter 3.1 — Health Systems.

Universal health coverage (UHC) — The goal that all people obtain the services they need without financial hardship, the organizing aim of global health policy. Wikipedia — See Chapter 4.2 — Global Health and Trade.

Utilization management — Reviewing whether requested care is appropriate, a managed-care technique whose friction must be weighed against the value it protects. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Utilitarianism — The tradition, underlying strict welfarism, that builds social value from the satisfaction of individual preferences. Wikipedia — See Chapter 3.5 — Capabilities.

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Vaccine hesitancy — Delay or refusal of vaccination despite availability; the canonical case where communication, trust, and misinformation meet a measurable health and economic outcome. Wikipedia — See Chapter 4.4 — Social Media and Health Communication Economics.

Value-based health care — Porter's framing of maximizing the health outcomes achieved per unit of cost, the organizing idea behind value-based purchasing and outcome-based contracts. Wikipedia — See Chapter 3.10 — Strategic Purchasing and Commissioning.

Value-based insurance design — Tuning cost-sharing to the clinical value of each service — removing charges for high-value care, retaining them for low-value care — rather than to price. Wikipedia — See Chapter 3.7 — Insurance and Risk Protection.

Value-based pricing — Tying a medicine's price to the health benefit it delivers rather than to its production cost or the manufacturer's asking figure. Wikipedia — See Chapter 2.4 — Pharmacoeconomics.

Value-based purchasing — Buying care on measured quality and outcomes rather than volume alone; a quality overlay on the underlying payment mechanism, exposed to Goodhart's law. Wikipedia — See Chapter 3.11 — Quality and Safety Economics.

Value of a statistical life (VSL) — The marginal rate of substitution between money and fatality risk, used across transport, environmental, and health appraisal to monetize avoided deaths. Wikipedia — See Chapter 3.12 — Pandemic and Emergency Preparedness Economics.

Value of information — An analysis estimating what it would be worth to reduce uncertainty before deciding, turning "we're not sure" into a number a research budget can act on. Wikipedia — See Chapter 2.2 — Modelling.

Variable cost — A cost that rises with activity — consumables, some staffing, drugs. Wikipedia — See Chapter 1.4 — Supply of Healthcare.

Vendor lock-in — The condition in which switching away from a supplier costs so much — data migration, retraining, re-integration, clinical disruption — that the buyer has lost effective bargaining power; in health, aggravated by patient data held in proprietary formats. Wikipedia — See Chapter 5.4 — Software Engineering Health Economics.

W

Waiting list — Rationing by delay, which allocates non-urgent care and, if unmanaged by need, quietly disadvantages the less assertive. Wikipedia — See Chapter 3.3 — Rationing.

Wearable technology — Body-worn devices that collect physiological data outside a clinical setting, feeding remote monitoring and digital care. Wikipedia — See Chapter 5.2 — Digital Health Economics.

Welfare economics — The branch of economics concerned with social value; in its standard, welfarist form it counts only individuals' utility. Wikipedia — See Chapter 3.5 — Capabilities.

Well-being — The broad field of measuring how well people's lives go, encompassing capability and subjective wellbeing as distinct traditions. Wikipedia — See Chapter 3.5 — Capabilities.

Whitehall studies — Studies of British civil servants showing a smooth social gradient in mortality, not merely a gap at the bottom. Wikipedia — See Chapter 1.5 — Determinants of Health.

Willingness to pay — A stated-preference basis for monetizing health benefit in cost–benefit analysis. Wikipedia — See Chapter 2.1 — Economic Evaluation.

World Bank — A multilateral bank that is a major channel of development assistance for health and sets the income classifications governing donor transition. Wikipedia — See Chapter 4.2 — Global Health and Trade.

World Health Organization (WHO) — The UN health agency that carries health-economics methods into low- and middle-income settings and stewards global health goods. Wikipedia — See Chapter 1.1 — Introduction to Health Economics.

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