(12) Resource Allocation And Healthcare Economics

Question 1

What is the impact of scarce resource on the work of doctors?

Answer 1

Patients receive less than best possible treatment

Question 2

What is the inevitability of rationing in healthcare systems?

Answer 2

Scarce resources - demand > supply

Needed to sustain publicly funded health care

Question 3

What are the approaches to resource allocation?

Answer 3

Explicit rationing

Implicit rationing

Question 4

What is cost effectiveness analysis?

Answer 4

Compares treatments that have a common health outcome (e.g. reducing blood pressure)
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Compared in cost per unit outcome
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If cost and benefits are high = calculate extra benefit obtained for the extra cost
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Is extra benefit worth extra cost?

Question 5

What is cost benefit?

Answer 5

All inputs/outputs in monetary terms
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Compares interventions outside healthcare
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Difficulty = putting monetary values on non-monetary benefits (e.g. saving lives)
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“Willingness to pay” often used

Question 6

What is cost minimisation?

Answer 6

Outcomes assumed to be equivalent 
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Focus on costs (inputs)
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Not relevant as outcomes rarely equivalent

Question 7

What is cost utility?

Answer 7

Type of cost effectiveness analysis
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Compares quality of health outcome produced/forgone
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Uses QALYs
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Compares in cost per QALY terms

Question 8

What are the advantages of using QALYs?

Answer 8

?

Question 9

What are the disadvantages of using QALYs?

Answer 9

• controversial
• doesn’t distribute according to need
• may disadvantage common conditions
• technical problems with their calculations

Question 10

What is explicit rationing?

Answer 10

Uses institutional procedures for systematic allocation of resources

Question 11

What is implicit rationing?

Answer 11

Allocation of resources through individual clinical decisions without criteria being explicit

Question 12

What is the role of NICE?

Answer 12

Provides guidance on whether treatments can be recommended for use in NHS