economics Flashcards
public good
non rivalness, non exclusiveness
discounting
human preference to want benefit now then in the future
efficiency x3
technical: maximum output for inputs
economic: maximum output for a given expenditure
allocative: marginal benefit is greater than marginal cost
PED (price elasticitic of demand)
percentage change in quantity demanded/ percentage change in price
recurrent spending
Ongoing operational expenditure eg salary
capital spending
expenditure results or enhancing an assett
Incremental cost effectivness ratio
total cost of new - total cost of old/ outcome of new- outcome of old
economic evaluation factors to consider
- design
- target audience
- perspective (societal, government, patient)
- target population
- intervention definition and boundries
- time horizon
- compartor
- costs
- health outcomes: DALY, QALY
- design = RCT. modelling
what determines demand
- price elasticity
- income
- taste and preference
- complements/ substitutes
income elasticity of demand
percentage change in quantity demand/ percentage in income
luxurary good >1 (rises as income increase_
normal good > 0
Inferior good <0
free market
atomicity
homogeneity
free entry
equal access
perfect information
no externalities
externality
This is a side effect of the product that is not traded on the market
positive: herd immunity
negative: passive smoke
marginal cost
marginal benefit
marginal cost: cost of producing one extra unit
benefit: the benefit from one extra unit produced
economy of scale
amount produced increases –> average cost goes down to a POINT
then cost goes up –> diseconomies of scale
features of healthcare
supply and demand not independent
imperfect market
immediacy
agency
uncertainty
necessity
(moral hazard?)
funding methods
weighted capitation
money per head, and other weights (age structure, deprivation, need)
recurrent baseline:
- previous years money + adjustments
distance from target- difference between WC and distance from target
pace of change policy: extra resources needed
financial incentives
payment by results: HRG (payment by activity)
fee for service: given money per activity (eg vaccinations)
payment for performance:
(penalty)
- delayed discharge have to pay
- social care bed, LA have to pay
incentive:
- QoFs
economic evaluations
CBA
- monitry units
can compare different interventions
CEA
natural unit
same disease
ICER
cant compare different diseases
CUA
use a utility measure eg QALY
can compare different interventions
issues: not health
how to prioritise
- save to invest
- PBMA
- MCDA
how to value life in monetary terms
- human capital
- value productivity eg wages
good: simple, objective
bad: older/children, true measure - Hedonic wage/ Reveled preference
- how much people are paid extra for dangerous jobs eg solider
good: reflect real choice, simple
bad: imperfect market, bias in those jobs picked, chronic disease - Stated preference
- contingent valuation: work out WTP to stay in health state
- discrete: ask to choose different interventions based on cost
good: any intervention
bad: true, costly, groups selected
QALY utility
- rating scale
- given scale, ask to put health states on scale - time trade off
- people asked how many years of perfect health willing to give up for life in health state - standard gamble
- have disease asked to gamble to either die or be cured - person trade off
- asked to trade off cure for different people in different health states
economic models
- Decision trees
- markov model:
- chronic disease
- well->disease-> dead
- transition probability
- time and repeated events
issues: data quality, memory less, difficult to include interactions between pts.
economic model uncertainty
methodological: right perspective
generalisability
parameter:
model structure: model assumptions
heterogeneity: different subgroups with different parameters
