Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Unit 12 week 2 (Sam) > Introduction to health economics > Flashcards

Introduction to health economics Flashcards

1
Q

LOs

A
  • Understand scarcity, efficiency and oppurtunity cost and be able to apply these concepts to health
  • Understand the difference between the basic types of economic evaluation and how outcomes are measured
  • Be aware of concepts of equity and rationing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Key objectives of economic analysis

A
  1. To promote the efficient use of healthcare resource
  2. To ensure the maximum total benefit is derived from the finite resources available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Scarcity of resources

A

There are limited resources within healthcare systems

Therefore there is a need for efficiency, to maximise utility out of the resources available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Oppurtunity cost

A
  • The cost of the next best alternative, foregone when an economic transaction is made.
  • Choosing one treatment to fund means that funding cannot be spent on another treatment.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why was NICE established?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Definition of economic evaluation

A
  • A comparitive analysis of alternative courses of action in terms of both costs and consequences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of cost

A
  1. Direct cost (health and social services) + (non-health services)
  2. Indirect costs (wider cost implications)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Examples of Health and social resource use

A

Inpatient

outpatient

test

drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Examples of non-health resource use

A

Patient transportation

informal care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Indirect costs

A

Wider cost implications e.g. lost production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of outcome

A
  1. Measured in natural units (drug that lowers BP, measure BP)
  2. Proxy outcomes (cancers detected, change in cholesterol level)
  3. Condition specific measures (CAT-COPD assessment test)
  4. Generic measures (life yers gained)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Valuing health: Quality adjusted life-years (QALYs)

A
  • Combines length and quality of life (‘utility’) into single unit to capture utility of treatment
  • Used to weight life years based on QoL
  • Quality of life: value health states with a mamimum value of 1 (perfect health) and value of 0 equivelant to death

QALY+ Σ((length of life) x (QoL) e.g. times period of life by QoL then add up these periods together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Euro-QoL EQ-5D

A

Questionnaire that covers all aspects of a patients life:

  1. Mobility
  2. Self care
  3. Usual activities
  4. Pain/discomfort
  5. Anxiety/ depression

Within each of these dimensions are 3 levels (new version has 5), each assigned a value.

Essentially (no problems-1, problems-2, extreme problem-3).

Sum up the answers to produce a QALY number

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

QALY calculation

e.g. QALY w treatment = 10

QALY wo treatment = 7.43

A

QALYs gained = QALYs with treatment - QALYs without treatment

10 - 7.43 = 2.57 QALYs gained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The Cost-effectiveness plane

A

Used to compare the cost effectiveness of 2 drugs

  • Dominant treatments will be accepted
  • Dominated treatments will not be accepted
  • Use ICER to determine if extra cost is worth extra efficacy (vice versa)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dominant treatment option

A

More effective and cheaper

17
Q

Dominated treatment

A
18
Q

ICER

A

Incremental Cost Effectiveness Ratio

ICER= (cost of new treatment-cost of standard treatment) / (consequences of new treatment - consequences of standard)

ICER = (Difference in cost) / (Difference in consequences)

19
Q

An intervention currenlty used by NHS costs £8000 and has a benefit of 0.5 QALYs. A new intervention costs 10,000 and has a benefit of 1 QALY.

What is the ICER?

A

10,000 - 8,000 = +2,000

1 - 0.5 = 0.5

2,000 / 0.5 = £4,000 per additional unit of benefit (e.g. QALY)

20
Q

Main types of economic evaluation

A
  1. Cost effectiveness analysis
  • Must choose ONE single outcome
    • Increased survivial
    • Reduction in symptoms
  1. Cost-utility analysis (NHS preffered)
  • Must consider quality of life
  • Quality Adjusted Life Years (QALYs)
  1. Cost-benefit analysis
    * Measures benefits in monetary terms
21
Q

Cost-effectiveness analysis

A
  • One of the main techniques used
  • Consequences in most appropriate natural or physical units (e.g. BP)
  • Decision rule: dominance (less costly, better outcomes) or ICER
  • Results in terms of “cost per unit effect” e.g. cost per cancer detected
22
Q

Hypothetical example of Cost effectiveness analysis

Assume a trial of 2 alternative chemotherapy regimes (A & B) for ovarian cancer. The main outcome measure is survival at 1 year.

A. B.

Mean cost. £45,900. £23,450

Survivors at 1 year. 33. 29

A

ICER = (23450-45900) / (29-33) = £5612.5 per additional survivor

23
Q

Cost-utility analysis (CUA)

A
  1. Outcomes are measured in Quality Adjusted Life Years (QALYs) gained
  2. Combine life years and quality of life
  3. Can be used to compare across treatment areas
  4. Decision rule: dominance or CU ratio
  5. Results in cost per additional
  6. Required by decision makers (e.g. NICE)

Is NHS preffered

24
Q

Decision Rule

A
  • NICE consider a new therapy to be cost effective if the cost per QALY is less than £20,000
  • £20,000 to £30,000 per QALY is an area that will be considered taking other factors about uncertainty into account
  • Cancer fund allows more expensive treatment therapies to be funded

Acts as a threshold in attempts to facilitate clear and consistent decision making.

“No” decisions are still unpopular and “Yes” decisions still have a cost.

25
Q

Equity in the NHS

A
  • Fairness in distribution of healthcare and health outcomes
  • Attempt to address equitable concerns reuires departure from pursuit of maximisation (of QALYs, etc.) to ensure a more equal distribution (a QALY of someone who is going to die is not the same as a QALY of someone who broke their arm)
  • What do we want to distribute fairly?
    • Health
    • Use of health care
    • Access to health care
26
Q

Types of equity

A
  1. Horizontal equity
  2. Vertical equity
27
Q

Horizontal equity definition

A
  • People with equal healthcare needs receive equal access to treatment irrespective of demographics
  • Factors/barriers e.g. geography, waiting times, patient information
28
Q

Vertical equity defintion

A
  • Individuals with unequal needs should be treated according to their differential need
  • Obvious but operationally difficult
  • How unequal do conditions need to be in order to pursue equity objectives (chronic versus trivial complaints)?
29
Q

Types of rationing

A
  1. Explicit rationing
    • Denial (ineligibity, cot considerations, “postcode lottery”)
    • Delay (e.g. waiting times)
    • Deterrence
    • Dilution (e.g. reduced time with patients)
  2. Implicit rationing
  • Efficiency
30
Q
A

Unit 12 week 2 (Sam) (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions