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YEAR 1 MED > Health economics > Flashcards

Health economics Flashcards

1
Q

(Health) economic principles…

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2
Q

what are economic resources?

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3
Q

Opportunity cost?

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4
Q

example of opportunity cost…

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5
Q

Rationing - the economists view…

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6
Q

Efficiency principle…

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7
Q

what is the difference between implicit and explicit rationing?

A
  • Implicit rationing: care is limited, but neither the decisions nor the bases for those decisions are clearly expressed
  • Explicit rationing: care is limited and the decisions are clear, as is the reasoning behind those decisions
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8
Q

what is the definition of health economics?

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  • the application of the discipline and tools of economics to the subject matter of health
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9
Q

what is economic evaluation?

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  • the comparative analysis of alternative courses of action in terms of both their costs and consequences
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10
Q

what are the 4 types of economic evaluation?

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11
Q

What is a QALY?

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12
Q

Cost-effectiveness plane…

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13
Q

what is an ICER?

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  • Incremental cost-effectiveness ratio
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14
Q

how do we decide whether an intervention is cost-effective?

A
  • estimate the ICER: mean difference in cost / mean difference in QALYs (ie. cost per QALY)
  • compare the ICER to the cost-effectiveness threshold (what society is willing to pay for a QALY / is seemed good value for money)
  • is the ICER below the cost-effectiveness threshold?
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15
Q

what is NICE threshold for cost-effectiveness?

A
  • between £20,000 and £30,000 per QALY
  • a cost per QALY below this value is generally considered to constitute value for money, whereas a cost per QALY above this value needs ‘special’ reasons for approval
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16
Q

Measuring QALYs with EQ-5D…

17
Q

Calculating the QALY gain…

18
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Types of economic evaluation (4 types) and questions addressed…

19
Q

Key features of the Beveridge model?

A
  • NHS funded from general taxation
  • It is free at point of use
  • Based on the principle of equal access for equal need
  • Provides universal coverage with some exemptions such as prescription charges and dental services
20
Q

Outline key features of health care system in the US?

A
  • Largely private insurance mainly funded through employment (ie. Many jobs come with health insurance)
  • There is a large public sector too (eg. Medicare)
  • Collectively, the US does not provide universal coverage
  • US is an expensive system (spends more on healthcare than UK)
21
Q

What is scarcity, opportunity costs and efficiency in relation to health care provision?

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  • Scarcity: shortage of resources (funding, staff)
  • Opportunity costs: loss of health benefits by using resources for a different health need
  • Efficiency: obtaining the greatest health benefit from interventions using the available resources or obtaining a given health benefit in a way that minimises costs or resources
22
Q

Cost effectiveness…

A

Cost effectiveness…
- ICER = incremental cost effectiveness ratio
- as a service improves will cost more, balanced against improvements in outcomes
- eg. different frequencies of cervical or breast screening = difference in cost of new vs old divided by difference in outcome of new vs old
(- compare with cost effectiveness threshold - £20 -30 000
- what is society prepared to pay for QALY?)

23
Q

Limitations to universal coverage…

24
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Equity and health finance…

25
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Revenue collection…

26
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Different types of health coverage…

27
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3 different health systems…

28
Q

Health care in the UK (funded? GPs/hospitals)…

A
  • Health Care is funded by taxes, social insurance contributions, private health insurance or by individuals
  • GPs = self-employed (paid by number of patients/treatments)
  • Hospitals: payment by results, staff may have performance-related pay/pay progression
29
Q

WHO indicators for health system performance…

30
Q

Equity in relation to health economics and health systems

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  • Equity = fairness and justice - everyone should have equal opportunity for health and access to services
  • note: is not the same as equal distribution of services
  • consider ethnicity, age, sex, loaction (eg rural/ city), language, disability
31
Q

NICE

A
  • NICE = National Institute for Health and Care Excellence
  • note: part of Department of Health
  • publishes guidelines for use of new technologies, which treatments to use and for social care - considers all available evidence, costs and involves clinical teams to make decisions
  • aim to standardise care and reduce postcode lottery
  • regularly audit practices against NICE guidance

YEAR 1 MED (49 decks)

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