Class 7 - Health care economics Flashcards
Define health care economics
the study of supply and demand of resources and it’s affect on the allocation of healthcare resources in an economic system
What are the concept categories within health care economics
- availability of resources
- health care financing
- utilization of resources
poor resource access can result in what?
disparities
significant differences (disparities) are seen among populations based on:
- race and ethnicity
- socioeconomic status
- geographic regions
What resources are included for the delivery of high-quality services
- people, time, and talent
- land, buildings, and equipment
- knowledge of how to combine these resources
What is utilization of resources
- the concern with efficiency and distribution
- link to access
- is greatest among individuals with multimorbid chronic conditions
What are the attributes of health care economics
- cost effectiveness
- efficiency
- value
Health care economics attributes, cost effectiveness
- efficient and equitable decisions are made about the allocation of resources
- A combination of the seller’s production costs plus an additional increment that represents the seller’s profit
Health care economics attributes, efficiency
- determined by how resources are used
- can be thought of as avoiding waste (including waste of equipment, supplies, and people) or as using healthcare resources to get the best value for the money
Health care economics attributes, value
- health outcomes achieved per dollar spent
- remains largely unmeasured and misunderstood
HCE attributes, relations
↑ value + not cost efficient = ↓ efficiency = less sustainable
↑ value + cost efficient = ↑ efficiency
Why should nurses care about health care economics
- Nurses often learn issues that directly affect their patients and discharge (insufficient resources to pay out-of-pocket costs or to purchase medications)
- constant concern for cheating efficiencies in practice, reducing unnecessary waste, and working together to reduce the costs of care
Where does money come from to pay for health care in Canada
tax and equalization payments
Evolution of healthcare system, pre WWII
- privately delivered and funded
- hospital were avoided
- government involved in sanitation and quarantine (infectious disease)
- physicians had high social and financial standing
- Great Depression: unemployment rate 30%
Evolution of healthcare system, post WWII
- 1947, Sask did province wide universal hospital care plan
- 1957, Hospital Insurance and Diagnostic Services Act involved diagnostic and hospital services (50/50 cost sharing model)
- 1961, all 10 provinces participates in Hospital Insurance Diagnostic Plan Act
- 1962, Sask Medical Insurance Act - universal, provincial insurance plan to all Sask residents
- Sask docs strike, 23 days
- 1966 Federal government passes Medical Care Act - feds pay 1/2 province costs
Who is considered father of Canadian medicare
Tommy Douglas
Where does money come from for health care?
- federal government to provinces
- Canada health act
- MB (provincial) budget
- private insurance
Federal government to provinces
- equalization payments: fed transfer ‘equal’ amount to each province
- Canada social transfer (welfare): all province get it - must be spent on HC/ed & comply w/ CHA
- Canada health transfer: Canada health act
What are the five principles of the Canada Health Act
- public administration: public get a ‘watch dog’
- comprehensive: all health services (physician services, hospital care, medically required dental procedure)
- universality: all insured (citizen + PR)
- portability: service is covered if traveling
- accessibility
What are the highest spending in MB provincial budget
health and education
What can be done if health spending continues to increase
- move funds from one part of budget to another
- reduce health spending
- raise taxes :(
How many Canadians have some form of private health insurance
65%
How many Canadians have a third-party insurance plan/private pay situation
30%
What is considered ‘extra service cost’ in MB? What is paid out of pocket
- eye glasses/exams
- dental (if >3)
- drugs
- physio, OT, massage therapy
- psychologist, counsellor
Provide examples of which aspects of health care are NOT covered by govy
- nutrition
- mental health
- aging population
- co-morbidities
What are the types of resource distribution with health care services
- basic framework of services
- service classification
what are the types of services within Basic Frameworks of Services
- primary health care services: docs + nurses
- secondary health services: referred to specialist, long-term care, community
- additional health care services: drugs, IVF, vision, dental, therapy, insurance
What are the types of services with Service Classification
- public health services/prevention services: promote health, prevent disease, control infect. disease (vaccine, ambulaotry care)
- community care services
- hospital services
What examples of resources distribution is currently present in MB
- Regional Health Authority (5 total)
- Cancer Care
- Addictions Foundations
- Diagnostic services
- Cadham Lab
- Selkirk Mental Health Centre
Provide example os cost conscious nursing practice
- meeting patient needs rather than provider needs
- knowing and controlling costs
- evaluating cost effectiveness of new tech
- predicting and using nursing resources efficiently
- using research to evaluate standard nursing practices
- leaders and nurse managers ideally, would staff to avoid OT
- reduce waste
- EIP = better outcomes
What is the link between health care economics and nursing leadership
nurses are a major workforce within healthcare organizations and fulfill multiple roles
What 3 aspects make up healthcare costs
costs = price x utilization
Costs: a function of the prices in the utilization rates of healthcare services
- Price: the rate that health care providers set for the services they deliver, such as hospital rate or physician fee as well as the unit prices of medication and supplies
- Utilization: quantity or volume of services provided, such as the number of diagnostic tests provided or the number of patient visits
What causes health care costs to rise
- price inflation in meds and supplies
- growing labour costs
- Lack of appropriateness or effectiveness of some type of care
- consumer beliefs and attitudes
- healthcare financing
- pharmaceutical usage
- changing population demographics and disease patterns
What are the top reasons for hospital admins, according to CIHI (2018)
- child birth (most common)
- bronchitis
- acute MI
- pneumonia
- HF
- osteoarthritis
- mood disorders
Define health care disparities
the differences or gaps in care experienced by one population compared with another
What does the cycle of disparities look like
- access to care
- provider bias
- poor communication
- poor health literacy
- other factors
Example of groups at risk of disparities
r/t SDoH - poor structural SDoH = increase risk
- minority groups
- rural residents
- women and children
- people with disabilities
