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YEAR 1 > Health Economics > Flashcards

Health Economics Flashcards

1
Q

What are opportunity costs?

A

The value of potential benefits which could be obtained from a resource when choosing one alternative over another

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2
Q

What is efficiency and what are 3 types of efficiency in relation to health care?

A

Efficiency refers to obtaining the greatest output for a given set of resources. The ability to avoid wasting materials, energy, efforts, money and time.

Technical
Productive
Allocative

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3
Q

What is technical efficiency

A

The effectiveness with which resources can be used to achieve a desired health outcome.

An intervention is technically inefficient if the same or greater outcome is achieved with less resources.

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4
Q

What is productive efficiency?

A

Compares alternative interventions based on the relative costs of the different resources.

To minimise the cost or to maximise the outcome

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5
Q

What is allocative efficiency?

A

Measuring the extent to which available resources are allocated to individuals who will benefit the most.

e.g. a treatment may be more beneficial to a high-risk group of patients

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6
Q

What is an economic evaluation of a health intervention?

A

Comparing 2 or more alternative interventions and considering both the costs and benefits of all alternative interventions being compared

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7
Q

What is a technology appraisal and what does it involve?

A

The process of which NICE evaluate existing and new treatments

  • Review clinical and economic evidence
  • Considering the health impact - talk to patients, manufacturers, clinicians
  • Consider the cost effectiveness
  • Comparing QALYs - quality of adjusted life years
    • Normally of less than £20,000 per QALY = cost effective
  • Social value judgements
  • Pricing deals - patient access schemes
  • Looking at clinical trial data to produce mathematical models to predict likely costs
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8
Q

How long do the NHS have to make a NICE recommended treatment available?

A

Within 3 months of its date of publication (unless otherwise specified)

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9
Q

What is the cost-effectiveness threshold for NICE per QALY?

A

£20-30K

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10
Q

What is the role of NICE?

A

To improve outcomes for people using the NHS and other public health and social care services.
By producing evidence-based guidance and advice for health, public health and social care practitioners.
Operate and evaluate therapies through QALYs

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11
Q

What is the Advisory Committee on Resource Allocation?

A

Replaced ‘Resource Allocation Working Party’.

Geographical allocation of money based on CCGs

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12
Q

What are the stages of cost analysis?

A

Identification - what resources might be affected by the programme or treatment

Measurement - how will we monitor the levels of resource used

Valuation - what is the value of the resources used

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13
Q

What are the 4 types of economic evaluation?

A
  1. Cost-utility analysis - different interventions for different outcomes - (e.g. QALYs)
  2. Cost-benefit analysis - benefits valued in monetary terms, willingness to pay, non-health benefits
  3. Cost-effectiveness analysis - different interventions for same health outcome (e.g. life years saved)
  4. Cost-minimisation analysis - same health outcome with different costs
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14
Q

What is the most favourable section on the cost-effectiveness plane?

A

Dominant - intervention is more effective and less costly

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15
Q

What is incremental cost effectiveness ratio?

A

A summary measure representing the economic value of an intervention, compared with an alternative.

(ICER) = (change in costs)/(change in effects)

Expressed as QALY

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16
Q

What is a QALY?

A

Quality Adjusted Life Year - a measure of the value of health outcomes.
Including the length of life and the quality of life

17
Q

What is an Average Cost-Effective Ratio (ACER)?

A

The ratio of the cost to benefit of an intervention without reference to a comparator

ACER= COST/EFFECTIVENESS

18
Q

What is the concept of equity in health care?

A

It is about fairness and justice.
Everyone should have an equal opportunity to attain their full potential for health.
Takes into account the need of the individual

19
Q

What is the concept of equality in healthcare?

A

The equal distribution so that each individual receives the same amount.

-Equality may not be right as some individuals have different needs dependant on residency, ethnic group, sex, age, education, socioeconomic status, disability

20
Q

What is the Beveridge Model?

A

NHS - Healthcare care system provided through the government for the public through general taxation and national insurance

21
Q

What is the healthcare in the UK?

A

Universal, Government-funded health system

NHS - funded from general taxation
Free at point of use
Based on principle of equal access for equal need
Provides universal coverage although some exemptions such as med charges
GPs act as gate keepers and services now commissioned by CCGs
Lowest % of their GDP on health care than other European countries

22
Q

What is the US Health Service

A

Non-universal insurance system

Largely private insurance mainly funded through employment
Large public sector - medicaid, medicare
Does not provide universal coverage
Extremely expensive system
Obama care - attempt to make insurance compulsory

23
Q

What are disadvantages of the NHS compared to other countries?

A

Waiting times
Lower numbers of doctors and nurses per head
Hospital beds per head
Lower survival rates for breast and cervical cancer
Higher health-care amendable mortality
Higher infant mortality

24
Q

What are advantages of the NHS?

A

Universal coverage - available to all citizens
Equitable
Free at the point of access
Control costs in line with affordability

25
Q

What are the WHO goals of a well-functioning health care system?

A

Improved health
Responsiveness
Social and financial risk protection
Improved efficiency

26
Q

What are the 6 WHO building blocks for a healthcare system?

A 
Service Delivery
Health workforce
Information
Medical products, vaccines, technologies
Finance
Leadership/Governance
27
Q

What is the WHO definition of a health care system?

A

Total sum of all the organisations, institutions and resources whose primary purpose is to improve, promote, maintain health.

28
Q

What is the universal private health insurance system and which countries have this?

A

Mandatory private insurance, usually subsidised by the government for low-income citizens

Switzerland, Israel

29
Q

What is a universal public-private insurance system?

A

People receive healthcare via primary private insurance
Receive from the government if ineligible for private

Austria, Germany, Mexico

30
Q

What is universal public health insurance system and what countries have this?

A

Social insurance with both employer and employee contributions
If unemployed - eligible for free health care

Belgium, Croatia, Romania

31
Q

What is the Bismarck System

A

Employers and employees are responsible for funding their health insurance system through “sickness funds” created by payroll deductions. Private insurance plans also cover every employed person.

Germany, Austria, Switzerland

YEAR 1 (17 decks)

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