4th May

Question 1

What are the 3 key concepts in economics?

Answer 1

Opportunity cost
Efficiency
Marginal analysis

Question 2

What is opportunity cost?

Answer 2

Value of something when a particular course of action is chosen
What you must forgo in order to get something
Benefit or value of what was given up needs to be considered when making choices
Aim to minimise opportunity cost of our choices

Question 3

What are QALYs?

Answer 3

Quality Adjusted Life Years
Measure of output of health care than can measure all types of health effect
Include preferences that allow value of health condition of interest

Question 4

What is economic evaluation?

Answer 4

Comparison of 2 or more alternative courses of action in terms of costs and their outcomes
Used to ensure the value of the outputs from an activity is greater than the value of resources consumed by the activity
Application of concepts of opportunity cost and efficiency

Question 5

What is efficiency?

Answer 5

Maximising benefit for the resources used

Question 6

What is technical efficiency?

Answer 6

Meeting a given objective at least cost

Question 7

What is allocative efficiency?

Answer 7

Producing the output that matches consumer want

Question 8

Give examples of technical and allocative efficiency

Answer 8

Technical = organising out patient follow up clinics ie virtual clinics to maximise numbers seen 
Allocative = is follow up necessary?

Question 9

What is marginal analysis?

Answer 9

Compares the benefit from the next step (marginal benefit)

with cost of taking the step (marginal cost)

Question 10

What are the 3 types of economic evaluation?

Answer 10

1) cost effectiveness analysis (benefits measured in terms of clinical outcome)
2) cost utility analysis (consider quality and quantity of life)
3) Cost benefit analysis (considers resource use and health benefits in monetary terms)

Question 11

What is the incremental cost effectiveness ratio (ICER)?

Answer 11

Cost effectiveness analysis calculates the expected cost per additional unit of health produced by a new intervention compared to current practice

Question 12

What is the cost effectiveness threshold?

Answer 12

Maximum amount the health service will pay per unit of health gained
Represents maximum opportunity cost consistent with improving population health by introducing a new intervention

NICE threshold of £20-30k per QALY gained

Question 13

What is an option appraisal?

Answer 13

Structured process for identifying, describing and evaluating alternative methods of achieving an agreed objective

Question 14

What are the key steps in an option appraisal?

Answer 14

1) define objective and constraints
2) identify and describe options
3) identify and quantify monetary costs and benefits
4) assess risks
5) identify and quantify non monetary costs and benefits
6) weigh non monetary costs and benefits
7) assess balance of advantage between options

Question 15

What are examples of constraints?

Answer 15

Time
Budget
Skill level
Legal

Question 16

How do you identify options?

Answer 16

What to provide?
Where to provide?
Who provides it?
How is it provided?

Question 17

Describe non monetary costs and benefits

Answer 17

QoL 
Access - will everyone be able to access service 
Health outcomes 
Quality of care indicators 
Patient safety 
Patient preference 
Adherence, compliance 
Staff experience

Question 18

How can you identify monetary costs and benefits?

Answer 18

NHS costs for additional time
Cost for equipment
Costs of supervision
Costs of NHS clinic/ lab space