Allied Resources Flashcards
Why do we set priorities?
Demand outweighs supply due to scarcity resources
Difficult decisions have to be made about whether treatments can be incorporated into the NHS
What are the 2 types of rationing?
Explicit: based on rules of entitlement
Implicit: decisions made on individual basis as care is limited
Describe what implicit rationing is.
Allocating resources through individual clinical decisions without using rules of entitlement. Treatment can be influenced by individual bias.
Describe explicit rationing.
Set rules and assessments that decide which treatments get resources so it is more fair and equitable.
Pros and cons of explicit rationing
+ accountable, equitable, more evidence based, opportunity for debate on resource allocation
- complex, not all patients can be treated the same, impact on clinical freedom, hostility between patient & health staff
What factors do we need to consider before giving resources?
- strength of evidence
- effectiveness
- no. of people who benefit
- patient acceptability
- equity
- treatment alternatives
- costs
- societal benefits
How is NICE involved in resource allocation?
They set guidances for deciding whether a treatment should be funded or not.
Also review current treatments and try to get new treatments out to patients ASAP to promote national equal access.
Despite NICE trying to make treatments more equally accessible, why would some local providers not following their new guidelines?
Local budgets might not be able to fund new expensive treatments so they can’t keep up with the demand.
What concepts do you need to consider in health economics?
Scarcity Efficiency Equity Effectiveness Utility Opportunity cost
How does opportunity cost affect new treatments?
Affects whether or not you could have spent the money on other treatments (sacrificing one treatment for another). Hence you measure opportunity cost in BENEFIT FOREGONE.
What are the 2 types of efficiency you can consider when making decisions?
Technical: most efficient way of meeting a need
Allocative: choosing between the many different needs that need to be met
What costs does the NHS need to think about when considering new treatments.
Cost of the healthcare services Cost of patient’s time Costs associated with care giving Other costs associated with illness Costs from employers, employees & society
How would we know that resource allocation to a particular treatment has been beneficial?
Impact on health status
Savings in other healthcare resources
Improved productivity (work, home)
How can you compare costs and benefits?
Cost minimisation analysis: (assume all outcomes are the same) so you choose the cheapest method to get to that one desired outcome.
Cost effectiveness analysis: comparing treatments depending on cost and benefits (is extra benefit effectiveness worth the extra cost?
Cost benefit analysis: look at how much people are willing to pay in order to continue with a treatment, (how much are people willing to pay to ‘survive’?)
Cost utility analysis: type of cost effectiveness analysis that focuses on prolonging quality of life (quality adjusted life years)
What is QALYs?
A standard, fairer way of measuring benefits & cost balance.
Benefits must include the length of life (survival) and quality of life
