international HC Flashcards
4 indicators to compare health care systems
equity
cost
efficiency
responsiveness
what is equity?
refers to fairness of distribution of health care resources in given society
what is equity in access
universal access
- all citizens able to obtain services on basis of need rather than ability to pay
- every high-income country provides universal except? US
what is one SDG goal?
universal health care coverage for all.
equity + Socioeconomic gradient?
does not translate into equal health outcomes
HC system doesn’t fix inequities in longevity + health experience
universal access + equal access
health status (need) strongest predictor of seeking out primary care (family doc), income + education are strongest predictors of specialist care (diff in education +income).
cost - money spent on HC in 2015
money spent in 2015 = 7.3 trillion
how much of world’s economic output is HC?
10%
cost - annual growth in health expenditures FROM 2000-2015?
- implications?
4%. economic growth averaged 2.8%
-> more spending than growth. managing cost is becoming difficult
low-and middle- income countries. spending vs populations?
20% of global health expenditures
80% of popln
which health system is costliest?
US
comparing health expenditure by govt/personal across high income countries
-> how much money needed for better health outcomes?
US has more personal costs than anyone else.
- > US spend more on health, but lower health expectancy
- > Japan has highest health expectancy, and spent less than average on health.
medication cost - issue?
barrier for patients in Canada. more than elsewhere.
- > 90% of primary care docs report their patients have difficulty paying.
- > Canada has above average cost of medications (still better than US tho), decrease cost of private meds (prescribed) more ppl access + adhere to regimen - more health - long term advantage
what is efficiency?
resources allocated are spent in best possible way to achieve health-related outcomes.
what is technical efficiency?
equal/better outcomes at lower cost.
low-cost, high-impact
generic drugs > patented
c-section: more unnecessary - more cost.
compare technical efficiency btw US and Canada
Canada more efficient
- main reason is administration cost. Canada is non-profit, public health oversees.
US = beaurocratic layer- insurance companies separate = 4x higher than Canada
what is allocative efficiency?
optimal mix of services that maximized well-being of popln
- whether should be treated + how much?
- if country spends lots on health, other areas (ed, pension) have fewer resources. overall is that benefit or bad?
-> preventative > curative? how many docs, nurses etc? how many ppl ,what is goal?
comparing # docs to avoidable mortality
more docs - should be better health outcome. no relationship. may increase control/limiting - increase ppl working to have more docs/nurses
density of docs in rural vs urban areas
Canada - fewer in rural than average. docs prefer urban - issue in allocation, maybe incentivize?
what is responsiveness?
how well HC system meets needs and expectations of citizens
-> respect for person, confidentiality, attention to emergency, wait times, and choice (choice in how care will affect)
Canada timely access - compare to average + other ocuntries
below average.
-> investment from fed on wait-time. had effect but still need improvement
comparing knee replacement across provinces
what is “reasonable time” determined by province.
- lots of variability across. quebec > NS and BC because average is low.
where does canada rank in HC system compared to other countries?
30/150
in 2002. presumably not much has changed tho.
