international HC

Question 1

4 indicators to compare health care systems

Answer 1

equity
cost
efficiency
responsiveness

Question 2

what is equity?

Answer 2

refers to fairness of distribution of health care resources in given society

Question 3

what is equity in access

Answer 3

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

Question 4

what is one SDG goal?

Answer 4

universal health care coverage for all.

Question 5

equity + Socioeconomic gradient?

Answer 5

does not translate into equal health outcomes

HC system doesn’t fix inequities in longevity + health experience

Question 6

universal access + equal access

Answer 6

health status (need) strongest predictor of seeking out primary care (family doc), income + education are strongest predictors of specialist care (diff in education +income).

Question 7

cost - money spent on HC in 2015

Answer 7

money spent in 2015 = 7.3 trillion

Question 8

how much of world’s economic output is HC?

Answer 8

10%

Question 9

cost - annual growth in health expenditures FROM 2000-2015?

- implications?

Answer 9

4%. economic growth averaged 2.8%

-> more spending than growth. managing cost is becoming difficult

Question 10

low-and middle- income countries. spending vs populations?

Answer 10

20% of global health expenditures

80% of popln

Question 11

which health system is costliest?

Answer 11

US

Question 12

comparing health expenditure by govt/personal across high income countries
-> how much money needed for better health outcomes?

Answer 12

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.

Question 13

medication cost - issue?

Answer 13

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

Question 14

what is efficiency?

Answer 14

resources allocated are spent in best possible way to achieve health-related outcomes.

Question 15

what is technical efficiency?

Answer 15

equal/better outcomes at lower cost.
low-cost, high-impact
generic drugs > patented
c-section: more unnecessary - more cost.

Question 16

compare technical efficiency btw US and Canada

Answer 16

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

Question 17

what is allocative efficiency?

Answer 17

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?

Question 18

comparing # docs to avoidable mortality

Answer 18

more docs - should be better health outcome. no relationship. may increase control/limiting - increase ppl working to have more docs/nurses

Question 19

density of docs in rural vs urban areas

Answer 19

Canada - fewer in rural than average. docs prefer urban - issue in allocation, maybe incentivize?

Question 20

what is responsiveness?

Answer 20

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)

Question 21

Canada timely access - compare to average + other ocuntries

Answer 21

below average.

-> investment from fed on wait-time. had effect but still need improvement

Question 22

comparing knee replacement across provinces

Answer 22

what is “reasonable time” determined by province.

- lots of variability across. quebec > NS and BC because average is low.

Question 23

where does canada rank in HC system compared to other countries?

Answer 23

30/150

in 2002. presumably not much has changed tho.