Health Economics Flashcards
What is health economics?
Drug development and use in perspective to health and incentives/constraints on clinical decision makers
What are the primary methods of funding health systems?
Taxation of the state Social health insurance Voluntary of private health insurance Out of pocket payments Donations to charities
What is healthcare equity?
Fair system of sharing health benefit and cost across community
What are the 3 concepts of efficiency?
Technical efficiency
Productive efficiency
Allocative efficiency
What is technical efficiency?
No resources wasted
Highest possible therapeutic benefit for given amount of drug
What is productive efficiency?
Compares alternative interventions for maximum benefits
What is allocative efficiency?
How resource is allocated to those who will benefit the most.
What is horizontal equity?
Equal treatment of equals
People viewed as equal in terms of need are able to access and benefit from a healthcare intervention
What is a vertical equity?
Unequal treatment of unequals
People viewed as unequal in terms of need may be offered different types of treatment
What are financial costs (direct) to the intervention?
Provider costs - drugs, staff
Capital costs - buildings, equipment
What are non-financial (indirect) costs involved with the intervention?
Patient costs - travel, prescription charges
Stress, pain, side effects
Productivity costs
What are the 5 basic methods of economic evaluation?
Cost minimisation analysis Cost effectiveness analysis Cost utility analysis Cost benefit analysis Cost consequence analysis
What is the cost minimisation method?
When outcomes are the same so select lowest cost
What is cost effectiveness analysis method?
Single outcome measures.
Natural units - life years gained, deaths avoided
What is the cost effectiveness ratio?
CER = costs of intervention / Health effects produced (eg life years gained)
What is incremental cost effectiveness ratio?
ICER = difference in costs between programmes 1 and 2 / difference in health effects between programmes 1 and 2
What does the ICER value mean?
Larger ICERs indicate that the cost of obtaining a unit of outcome is higher
Negative ICER means that improvement in outcome and reduction in costs
What is the most common measure used in utility (CUA)?
QUALY - combines survival periods (quantity of life) + health status valuations (quality of life).
1 QUALY = 1 year in perfect health
What are the advantages and disadvantages on CUA? (Cost Utility Analysis)
Advantages
Allows comparisons for interventions for different conditions
No need to put a monetary value on health state
Can evaluate morbidity and mortality
Disadvantages
Cannot discriminate in mild conditions
Assumption do not hold in chronic conditions
Utility attached to health is often dependent on person experiencing health state
What is risk ratio (RR)?
Ratio of two absolute risks
The probability of an outcome in an exposed group to the probability of an outcome in the control group
What does a RR of 1 mean?
There is no difference between risk in each group
What does a RR < 1 mean?
Event is less likely to occur in the experiment group than in control group
What does a RR of > 1 mean?
Event is more likely to occur in the experimental group and than the control group
What does NNT mean?
It is the average number of patients treated for one to benefit compared to a control group.
Ideal NNT = 1
Measures the effectiveness of the intervention
