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Public Health 3b > Health economics > Flashcards

Health economics Flashcards

1
Q

What is opportunity cost?

A

the opportunity cost of an activity is the sacrifice in terms of the benefits forgone from not allocating resources to the next best activity

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2
Q

When is economic efficiency achieved?

A

economic efficiency is achieved when resources are allocated between activities in such a way as to maximise benefit

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3
Q

what is economic equity?

A

distributing the costs and benefits by what is fair and just

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4
Q

what does improving equity often result in?

A

improving equity often results in loss in efficiency i.e. funding the treatment of rare diseases for children will take away funding for common diseases for adults

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5
Q

what is economic evaluation?

A

economic evaluation is a comparative study of the costs and benefits of health care interventions

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6
Q

what are the 3 things that compromise an economic evaluation?

A

comparative study
costs
benefits

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7
Q

what 3 ways can a health benefit be measured?

A

monetary value
natural units - BP/pain score
QALY

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8
Q

how do you calculate a QALY?

A

length (years) x quality (utility)

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9
Q

what does one QALY represent?

A

1 year of perfect health OR 2 years in half perfect health

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10
Q

what does QALY’s allow?

A

comparison of life quality ad benefits across diseases

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11
Q

what are the 4 types of economic evaluation?

A
  1. cost effectiveness analysis
  2. cost utility analysis
  3. cost benefit analysis
  4. cost minimisation analysis
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12
Q

what is a cost effectiveness analysis?

A

simplest form of economic evaluation that uses natural units to measure health (i.e. incremental cost per life year gained)

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13
Q

give an example of a cost effectivness analysis?

A

it costs £10,000 per life year gained if the patient has a heart transplant, but £30,000 per life year gained if the patient has a hip transplant.

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14
Q

how is incremental cost effectiveness ratio calculated?

A

the difference in cost between two interventions (£) / the difference in their effect (life years, QALY)

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15
Q

give an example of an incremental cost effectiveness ratio?

A

existing scanning protocol £100,000 per year and detects 80 diseases, new scanning protocol costs £200,000 per year and detects 90 diseases
the ICER = (200,000-100,000)/(90-80) = £10,000 per extra case detected

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16
Q

what does the incremental cost effectiveness ratio show?

A

the difference in cost and the difference in benefit for two treatments

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17
Q

what is a cost utility analysis and what does it measure?

A

Measures health in terms of QALY’s

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18
Q

what is the current NHS funding threshold for QALY’s?

A

£20,000 per QALY

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19
Q

what are some other things that should be considered when deciding between treatments?

A 
age (equity)
severity of illness (equity)
end of life (equity) 
rarity of condition (equity)
causation (equity)
innovation (wider economic benefit) 
patient choice
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20
Q

what is a cost minimisation analysis?

A

The consequences of competing interventions are identical, so comparison can be made on the basis of resource costs alone. The aim is to determine the lowest-cost way of achieving the same outcome.

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21
Q

define health care economic “efficacy”?

A

The effect of an intervention under ideal conditions, with participants fully complying with the programme.

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22
Q

define health economics?

A

The study of how scarce resources are allocated among alternative uses for the care of sickness and the promotion, maintenance, and improvement of health

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23
Q

what is the definition of health years equivalent?

A

The hypothetical number of years spent in perfect health that are considered comparable to the actual number of years spent in a particular state of health.

24
Q

define incremental cost

A

The difference between the cost of a treatment and the cost of the comparison treatment.

25
Q

define “utility”

A

A measure of the ‘satisfaction’ (benefit) obtained from consuming goods and services.

26
Q

what is a disability adjusted life year?

A

The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death.

27
Q

what is the incidence?

A

number of new cases per time unit

28
Q

what is the prevelance?

A

number of existing cases at a particular point in time

29
Q

what is sensitivity?

A

the probability that the person with the disease obtains a positive results

30
Q

how is sensitivity calculated?

A

true positive/ (false negative + true positive)

31
Q

what is specificity?

A

probability of a person without the disease testing negative

32
Q

how is specificity calculated?

A

true negative / (false positive + true negative)

33
Q

what is positive predicted value?

A

the proportion of people with a positive test result who actually have the disease

34
Q

what is the negative predictive value?

A

the proportion of people with a negative test result who actually do not have the disease

35
Q

how is the positive predicted value calculated?

A

true positive/ true positive+ false positive

36
Q

how is the negative predicted value calculated?

A

true negative / true negative + false negative

37
Q

what is a case report or case series study?

A

study that examines individuals and is used to routinely collect data. is useful for generating hypotheses but not useful for causation

38
Q

what is a cross sectional study?

A

divides the population into those with and those without and compares at one point in time to find associations

39
Q

what is a case-control study?

A

retrospective study that takes people with disease and matches to those without the disease and study previous exposure to the agent in question

40
Q

what is a cohort study?

A

study that follows people without the disease over a period of time to see if they are exposed to the agent in question and if they develop the disease or not

41
Q

4 criteria that can be used to evaluate the likelihood that an association is causal?

A

consistency
strength of the association
specificity
coherence with existing theories

42
Q

what is the absolute risk and how is it calculated?

A

the probability that an event will occur in a group

number of the event in group/total number in the group

43
Q

what is the relative risk and how is it calculated?

A

Risk of the event occurring in one group compared to the other

i.e. people who take OCP have a 50% increased risk of cancer than those who do not take the pill

ART/ARC

44
Q

what is the absolute risk difference/reduction?

A

the absolute risk reduction is the amount by which an outcome is reduced (or increased) across groups

ARC-ART

45
Q

what is the number needed to treat?

A

the additional number you would need to treat in order to cure on extra person compared to the old treatment

the additional number needed to be exposed to the risk in order for one person to develop the disease comapared to the unexposed group

46
Q

how to calculate the number needed to treat?

A

1/absolute risk reduction

47
Q

define the odds of an event?

A

ratio of the probability of an occurrence compared to the probability of a non-occurance

48
Q

how to calculate odds

A

probability/1-probability

49
Q

disadvantages of an epidemiological study?

A

no time point
only measures average population
data may have originally be collected for other purposes
observation bias

50
Q

what is selection bias

A

Participants in research may differ systematically from the population of interest. e.g. study of influenza involves young healthy volunteers whereas those most likely to receive the intervention are elderly with comorbidities

51
Q

what is information bias

A

an error is made when measuring exposure or outcome variables that results in different quality or accuracy of information between the comparison groups

52
Q

what is recall bias?

A

cases are more likely to recall a prior exposure than the controls

53
Q

what are the two types equity?

A

vertical - equal care for equal need

horizontal - unequal care for unequal need

54
Q

4 things needed for capacity?

A

understands information
retains information
uses information to make a decision
communicates the decision

55
Q

what is relative risk reduction and how do you calculate it?

A

relative decrease of the event in a treatment group when compared to the non-treatment group - (ART/ARC)/ARC

Public Health 3b (2 decks)

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