introduction to resource allocation and health economics Flashcards
what is priority setting
allocation of resources between competing claims of different services
what is rationing
describes the effect on the individual to the extent patients receive less than the best treatment
why do we have rationing and priority setting
because demand outstrips supply and NHS expenditure keeps increasing driven by demographics e.g aging population and more people with chronic condtiaionts
what are the 2 forms of rationing
explicit rationing- based on defiant rules
implicit rationing- care is limited but the basis of there decisions are not clearly expressed
advantages and disadvantages of explicit rationing
its a very systematic approach. makes it more fair and these decisions are clear and evidence based. However, this may cause patients distress as one rule necessary does not fit all cases
advantages and disadvantages of implicit reasoning
very open to abuse. it may lead to discrimination and also many doctors asked said they felt uncomfortable making these decisions. However, rules can be applied better to individual cases
how is explicit rationing decided
strength of evidence, effectiveness, number of people benefiting, costs, patient acceptability, national requirements, equity, societal benefits, treatment alternative and strength of local feeling
what is NICE?
national institute for health and care excellence, sets guidelines for whether treatments are recommended for in the NHS UK.
how NICE guidelines work
once national guidance by NICE is issued it replaces local recommendations and therefore promotes equal access for patients across the country. however this is not always the case as local authorities can decide whether they want to comply by these guidelines. can go lower but not higher. e.g in Leicester only have 1 IVF treatment when 3 are recommended. if the treatment is approved might be able to find it in some areas but if not then can’t have it anywhere in England
what is health economics
In broad terms, health economists study the functioning of healthcare systems to help decisions of resource allocation by doctors as they are involved in these decisions
explain the basic concepts of health economics (resource allocation)
scarcity- need outstrips resource
efficiency- getting most out of resource
equity- extent to which distributions of resources is fair
effectiveness- extent it produces desired outcomes
utility - value an individual places of health
opportunity cost- cost of new treatments for what could be had for that some money
what is technical efficacy
when you are interested in the most effective way of meeting a need (e.g should neonatal care be community or hospital based)
what is allocative efficacy
choosing between the needs to be met (e.g choose between hip replacement or neonatal care)
how to undertake economic evaluation (how to compare costs)
cost minimisation - cheapest option, all outcomes are equivalent
cost benefit - monetary terms; willingness to pay
cost effectiveness- is the extra benefit worth the extra costs
cost utility- type of cost effectiveness, uses the QALY as the measurement
what is economic evaluation
comparison of resource implications and benefits of alternative ways of delivering care
