CBA (Exam 1 Cut Off) Flashcards

1
Q

CBA

A
  • Cost Benefit Analysis
  • Metod for comparing the value of all resources used (costs) for a program/intervention with the value of outcomes achieved (benefits)
  • Key: costs and benefits are valued using the same monetary unit
  • Ideally benefits are more than just material cost savings: should include evaluations that include indirect and intangible benefits
  • If benefits exceed the costs, program may be worthwhile
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2
Q

How does CBA differ from CEA?

A

CEA

  • Emphasis on minimizing costs to achieve optimal outcomes
  • Does not provide information on whether a project/intervention is worth investing the required resources - provides a relative measure
  • Addresses production efficiency

CUA/CEA
-Can assist with program decisions when outcomes are in similar units

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3
Q

Advantages/Disadvantages of CBA

A
  • CBA is braoder in scope than CEA
  • Using CBA, decisions about resource allocation can be made within AND between sectors of the economy
  • CBA addresses allocation efficiency
  • CBA does NOT address production efficiency
  • Not always easy to assign monetary values to non-monetary benefits if different methods used between CBA analyses, can also make comparison of findings difficult
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4
Q

CBA Questions

A
  • Evaluation of single treatment/service or comparison of multiple options
  • Given a limited budget, which program should be implemented?
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5
Q

Components of CBA

A
  • 2 cost and 3 benefit categories
  • Cost categories: direct medical and direct nonmedical
  • Benefit categories: Direct, indirect, and intangible
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6
Q

Cost

A
  • Summarizes costs involved with providing the treatment/service
  • Ex: Labor, equipment, operational expenses
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7
Q

Benefits

A
  • Include “cost savings” or “costs avoided”

- Reduction in costs because of an alternate program would usually be classified as a benefit: “Cost saving”

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8
Q

Steps Conducting CBA

A
  1. Reason for evaluation
  2. Identify and value costs
  3. Identify and value benefits
  4. Determine cost and benefit
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9
Q

Reason for Evaluation

A
  • CBA can provide a more complete picture of the total value

- Many treatments provide additional clinical benefits but at an additional cost

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10
Q

Identify & Value Costs

A
  • Direct Medical costs: pharmacist time, increased utilization of astham medications
  • Direct Nonmedical Costs: travel time for patient to clinic
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11
Q

Identify and Value Benefits

A
  • Easily measured monetary values with direct medical and nonmedical costs
  • Must assign monetary values to indirect and intangible benefits too
  • Two methods for assigning monetary value: human capital (70-80% of studies) and Willingness-to-Pay
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12
Q

HC Approach

A
  • Estimated increases of actual earnings/productivity because losses no longer occur
  • “Pay back” value of health benefits - person’s renewed or increased ability to be productive for society
  • Need wage rate and time gained
  • Limitations: Only considers time for employable persons, inequities due to degree of economic productivity, intangible benefits cannot be evaluated
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13
Q

Willingness-to-Pay

A
  • Estimate of how much someone willing to pay to not have an adverse outcome
  • Can be used to value both indirect and intangible benefits
  • Incorporates preferences
  • Limitations: measurement biases exist, difficult to place dollar values on intangibles, WTP tend to be higher than HC
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14
Q

VSL

A
  • Value of statistical life
  • Does not estimate the value of life
  • Average estimate of what an individual is WTP to reduce a certain risk level or accept a certain risk level
  • Varies based on associated risk and the population
  • Extensions in life expectancy are assigned a value for a statistical life-year
  • Large and controversial literature on the economic value of a life-year
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15
Q

Determining Costs and Benefits

A
  • Benefit Cost Ratio = Sum of Benefits/Sum of Costs
  • Net Benefit = Sum of Benefits - Sum of Costs
  • Meed to discount future projections greater than one year away
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16
Q

Criteria for Evaluating CBA

A
  • Program is Beneficial: NB > 0, B/C > 1
  • Neutral: NB = 0, B/C = 1
  • NOT Beneficial: NB <0 or B/C < 1
  • May need to consider IRR or hurdle rate
  • B/C ratios need to be approached with caution regarding the degree to which some components have been considered as costs or cost savings
17
Q

Hurdle Rate

A
  • Minimum return rate necessary to approve project

- Often the cost of acquiring capital or rate that could be earned on other investments

18
Q

IRR

A

-Rate of return where discounted benefits = discounted costs

19
Q

CBA Decision Rules

A
  • Criteria for decision depends on multiple factors
  • Include budget restraints, availability of funds to support program, context of evaluation, perspective of decision maker, whether the program fits in with long term strategies and goals
  • Also need to consider if there is a fixed budget and if there are alternative investments