Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

health Economics > Health care system comparison > Flashcards

Health care system comparison Flashcards

0
Q

what do you need to know what the performance is of health care system.

A

we need to know how much money went into the health care system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

what is the first step of a framework to understand the health system performance?

A

define the boundaries of the health system ,based on the concept of health action.
within these boundaries,the concept of performance is centred around 3 fundamental goals.

  • improving health
  • enchancing responsiveness to the expectations of the population
  • assuring fairness of financial contribution
    *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how do you define health action

A

it is any set of activities whose primary intent is to improve or maintain health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what do they mean with improving health

A

both increasing the average health status and reducing health inequalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how does a coherent and consistent framework should begin with

A

with a simple question : what are health systems for .
once the intrinsic goals of health systems have been clearly articulated ,these goals must be measured and both the concept of performance and the key factors that influence performance must be explored .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what kind of topics cover the conceptual basis for health system performance

A

the boundaries of the health system
the difference between intrinsic and instrumentaal goals
mapping between social systems and social goals
the main goal of a health system
the instrumental goals of a health system
the concepts of performance and efficiency
applying the concept of performance to subssystems or institutions
key factors influencing health care performances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the goals of the who

A
  • monitor and evaluate attainment of critical outcomes and the efficiency of the health systems in a way that allows ccomparisons over time and between different countries
  • build and evidence base on the relationship between the design of the health system and performance
  • empower the public with information relevant to their well being
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are dalys

A

is a measure of overall disease burden, expressed as the number of years lost due to ill health,disabilitt or early death

Interpretation : 1 year in perfect health is equal to 2 years in 50% health . we have an utility weight comparing to perfect health.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which kind of goals fullfil the intrinsic goals

A

is it possible to raise the level of attainment of the goals ,while holding the level of other intrinsic goalss constant

raising the level of attainment of an intrinsic goal s desirable

it is possible to improve on patient experiences while holding outcomes for health constant. we want all the goals we care about in the evaluation .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the distribution in this framework all about

A

about equity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

where do we look at when evaluating goals in the who framework

A 
health improvement
responsivness to expectations
fairness in financial contributions
average level 
distribution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

explain the content of responsivness

A

the legitimate expectations of the populations.

health improvement expectations of the public is excluded because it is already fully reflected in the 1st goal : health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which 2 major components does responsivness have

A

respect for persons : the interaction of individuals with the health ssystems and this has important ethicala dimensions

  • respect for dignity,for individual autonomy ad respect for confidentialitty

client orientation: it includes several dimensions of consumer satisfaction and is not a function of health improvement.

*prompt attention or health needs : this can lead to better outcomes ex. waiting for a diagnose
*basic amentities ; clean bed,good bed
acces to social support : allowing pets affect health outcome
* choice of provider

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what does the distribution of responsivness means here.

A

it is important to look at the average level of responsivness but also with ineaqualities in its distribution . we are implicity interested in differences related to social,economic,demographic and other factors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

fairness in financial contribution

which of the 2 key challenges should a health system have to be fair

A
  1. ) households should not become impoverished ,or pay an excessive share of their income in obtaining needed health care
  2. ) poor household should pay less towards the health system then the rich household ( fair share)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does fair share means

A

every household should pay a fair share towards the costs of health system. it might mean no payment at all for poor household

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the arguments for a fair share

A

redistribute income ; example by providing free health services to poor households
health systems that redistribute income are likely to give more acces to the poor and thus lead to bettter health outcomes ( instrumental )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

are we interested in the average level when we look at the finance contribution

A

no we are only interested in the distribution . the level of health financiering is a key policy choice in any society but it is not an intrinsic goal. it is always desirable to recieve a lot of health and responsivness here and it is not valuable to spend an ever increasig amount of money on the health system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the most important here

A

that the financial burden should be fairly distributed across groups.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

which concepts are related to the framwork.

A
  • quality is a subset of overall goal attainment,not a performance of measure
  • equity of the health system is broader than simple health inequalities
  • efficiency how well are the socially desired mix of 5 components of the 3 goals achieved compared to the available resources.
20
Q

how can we consider the whole framework

A

the level for health and responsivness is the overall quality of the health system because this framework is directly related to quality ,equity and efficiency.

the distribution of the 3 goals are the total equity of a health system.

21
Q

how do we weight goals

A

when you have the 5 goals,to come up with an overall figure of the health care system we need to weight the performance of each of these goals. we weight them by asking people about their preferences and how they would attribute their weight.

22
Q

is there a pareto efficiency when you look at the concept of performance between countries

A

a single budget for the health system is used to achieve all the goals but there can be a trade off.

some countries may perform poorly on responsivness but well on health inequality ,because more resources from the total budget are assigned to redressing inequalities then to enchancing responsiveness

23
Q

what are cross system goals for the health system and give an example

A

goals that could be potentially important and that should be the subjext of special analysis and evaluation.

example : how much does the health system help or hinder education. on of the most important cross system is the contribution of health system to the economic production .

24
Q

why is contribution important

A

because health and health systems may decrease or increase economic production
decrease : employment based insurance ,may hinder labour mobility and mamcro economic performance
increase : evidence shows that improvement in health can enchance economic growth

25
Q

explain the who health care system functions

A

service provision : personal and non personal health services
financing : revenue collection ,fund pooling and purchasing
resource generation : personnel ,facilities and knowledge

26
Q

what is important when you look at a health care system

A

information over time.
data so that we know if we have to adjust .

policy makers do have to make a decision by trying to raise the efficiency level at the expense of lowering inequalities.

it is very important to decide how to make an efficient trade off.

27
Q

what does equity means in health finance

A

it is the extent to which all forms off health payments ( taxes,social insurances,private insurance,oop) contribute to the redistribution of income.

28
Q

is the financial fairness in the netherlands good ? why or why not

A

in the past it used to be very good but not anymore because of the introduction of the own risk

29
Q

what are the 4 steps when you want to achieve a performance of health care

A
  1. ) identify goals
  2. ) measure them
  3. ) weight them
  4. ) adjust for the amount of money that goes into the system
30
Q

what happens when you introduce the veil of ignorance like franken en koolmaan did

A

people shift to the left

extra uitleg over de resultaten van hun onderzoek

31
Q

.c) Which of the goals (level or distribution) is most important behind a ‘veil of ignorance’?

A

Distribution of health followed by the level

32
Q

a) What are the health system goals according to Murray and Frenk of the WHO? Please explain the goals briefly.

•

A

Health (HALY) (level and distribution)
• Responsiveness (patient experiences, autonomy, dignity, provider choice etc) (level and distribution)
• Equity in financial contribution

33
Q

b) Why does the WHO differentiate between level and distribution of these goals?

•

A

Level captures the average attainment level

• Distribution captures the equity component.

34
Q

d) Should the relative importance of weights be determined behind a ‘veil of ignorance’? Why (not)?

•

A

A ‘veil of ignorance’ places respondent in their ‘original position’ and thus allows a value judgement that is not biased by the current obtained position in society.

35
Q

e) The quality of the Dutch healthcare providers is measured in terms of medical quality (proxies for health outcomes) and the Consumer Quality Index (CQI or patient experiences). How does this framework relate to that of the WHO?

•

A

Both focus on the patient perspective: health and process utility. Financial and distributional aspects are not incorporated in the provider quality measurement.

36
Q

f) Should the missing goals (levels and/or distribution) be incorporated in the Dutch provider quality measurement? Why (not)?

A

• No, equity considerations should not be solved at the provider level, but should remain at the health care system level, because they are the result of all the providers, not individual ones. It

37
Q

Give two major insights about competition and quality on health care markets that Gaynor discusses in his paper of 2006 entitled “What do we know about competition and quality on healthcare markets?”

A

monopolitist generally does not provide optimal quality
firm’s quality level depends on demand elasticities
- competition does not necessarily lead to optimal quality
- with regulated prices, competition leads to more quality
- if firms set both prices and quality, effect on quality less clear

38
Q

Healthcare systems comparisons differ in their approach. Please clarify the differences between the Euro Consumer Powerhouse and the Dutch Health Care performance report.

A

Uitleg volgt

39
Q

What are the differences between the framework of the who and the framework of koolman

A

The way assessing the opinion of people is different, the WHO assessed people subjective and Xander his work used a ‘Veil of ignorance’ wich means that he try to assess the opinion from people without using there own value of resent life.

40
Q

Intrinsic goals fulfil the following two criteria:

A

.- It is possible to raise the level of attainment of the goal, while holding the level of all other intrinsic goals constant. In theory, a given intrinsic goal is at least partially independent of all others.
- . Raising the level of attainment of an intrinsic goal is desirable. If it is not, it is probably an instrumental goal and not an intrinsic goal.

Instrumental Goals are goals help to reach intrinsic goals. They are more based on the way getting to intrinsic goals.

41
Q

What do they mean with
Revenu collection
Fund pooling
Purchasing

A

Revenue collection : mobilization of money from primary sources ( households and firms) and secondary sources ( governments and donor agencies).

Fund pooling : refers to the accumulation of revenues for the common advantage of participants. Contributors share financial risk

Purchasing : the proces through which revenues that have been collected in fund pools are allocated to institutionals or individual providers to deliver a set of interventions.

42
Q

What do they mean in the who with
Provision of health services
Resource generation.

A

Provision bestaat uit personal and non personal health services.

Resource generation : educational institutions like nursing schools,pharmaceutical industry,research

43
Q

According murray and frenk who: what should countries do with the intrinsic goals: health, responsivness,fairness in distribution

A

They should monitor them routinely.assessment of goal attainment are focused on measuring these 3 goals,to evaluate performance and efficiency .

44
Q

Koolman: which 3 outcome oriented objectives do health systems have

A

Health utility
Proces utility : responsivness
Equitable distribution of health

45
Q

Koolman : which framework do they use for cross country comparison

A

The oecd and who framework.

46
Q

Koolman: what is the disadvantage of using the oecd framework

A

It consists inputs and output variables so this could give rise to methodological problems when weighing goals

47
Q

Koolman: how did the who measured when valuing health system goals

A

Individuals through interner based questionnaire

health Economics (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions