HaDSoc 8.1 Resource allocation Flashcards
Why do we need to set priorities in healthcare?
Demand outweighs supply
We can’t fund everything we want to
Why is NHS spending increasing over time?
Why are demands increasing?
- Aging population (And as you get older the chances of you having chronic conditions increases)
- increasing incidence and prevelance of cancer
What are the 2 forms of rationing?
Which is used currently?
- Explicit rationing (currently used)
- Implicit rationing
Explain what is meant by implicit rationing?
There are no rules on who gets what treatment.
Care is limited but it is left down to clinical judgement who gets what care.
There is no explicit criteria.
What are the critiques of implicit rationing?
- Can lead to discrimmination and inequities
- Can decide who gets what based on ‘social deservingness (not ethical)
- Doctors often unwilling to do it
- can be abused
What reason do some doctors have for still seeing merit in the use of implicit rationing?
-all patients are individual and their circumstances are unique.
using this method of rationing takes that into account and allows more flexibility.
Explain what is meant by explicit rationing.
Care is limited but the decisions about prioritising are explicit.
Analysis and research is done to decide who gets what, and explainations can be made.
What are the advantages of explicit reasoning?
- transparency and accountability
- more evidence based
- more oppertunity for debate
- more likely to recieve equitable care.
What are some disadvantages of explicit reasoning?
- doesn’t necessarily account for the individual patient
- Complex
- can lead to hostility between the patient and practitioner
- restricts clinical freedom of the practitioner
What is the role of NICE in resource allocation?
- they approve treatments for use, and advise them but this doesn’t mean you MUST use this treatment.
- Once guidance of a drug has been issues, all patients across the country have equal access to it.
Why is NICE’s role in relation to expensive treatments considered controversial?
- If they’re not approved, patients are denied access to that drug (except in very special circumstances)
- If they are approved, they must be funded despite being expensive (which can have knock on effects for other treatments)
What does utility mean with regards to health economics?
-The value an individual places on a particular health state. (Is a certain outcome valued by the patient)
What does effectiveness mean with regards to health economics?
-is the desired outcome met by an intervention?
What is meant by oppertunity cost?
Once you decide to spend money on one thing, it can no longer be spent on other things.
Measured in terms of benefits foregone.
Cost viewed as a sacrifice.
It looks at whether that treatment is good value for money compared to the alternative uses of that money.
What are the 2 different forms of efficiency?
- technical efficiency
- allocative efficiency