Lecture 2: The Cost of Health Care, the Cost-Effectiveness of Technologies, Engineering 101 Flashcards

1
Q

What metrics go into a HTA?

A

Efficacy/Effectiveness, Performance of diagnostics,

Cost

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2
Q

TA: Litteneberg Model

A
  1. Biological Plausibility
  2. Technical Feasibility
  3. Clinical Trials
  4. Patient Outcomes
  5. Societal Outcomes
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3
Q

Biological Plausibility

A

Does the science support the technology?

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4
Q

Technical Feasibility

A

Can we safely and reliably deliver the technology to the patients who need it?

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5
Q

Clinical Trials

A

Do randomized clinical trials comparing the new technology to current standards show a benefit?

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6
Q

Patient Outcomes

A

Are patients better off with the new technology?

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7
Q

Societal Outcomes

A

What are the costs and ethical implication to society?

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8
Q

Why have US Costs Increased?

A
  1. Aging population
  2. Prescription drugs
  3. Administrative costs 4. Shift in type of providers
  4. Use of technology
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9
Q

QALY (Quality Adjusted Life Year)

A

a measure of disease burden, including both the quality and the quantity of life lived. It is used in assessing the value for money of a medical intervention.

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10
Q

How can technology drive costs down?

A
  • Cost reductions through increased outpatient procedures
  • Longer productive life span
  • Biotech for disease with high DALY
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11
Q

Difficulties in Developing World

A
  • Necessary technology does not exist
  • Technology exists but is not accessible
  • Accessible technology is not adopted
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12
Q

Engineering Design Method

A
  1. Identify a need
  2. Define the problem
  3. Gather information
  4. Develop solutions
  5. Evaluate solutions
  6. Communicate results
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13
Q

Incremental Cost-effectiveness Ratio (ICER)

A

Difference in cost/change in QALY = $ per QALY gained

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14
Q

What are the problems and solutions for technology not existing in developing countries?

A
  1. Funding issue
    - insufficient funding devoted to develop necessary technologies
    - Solutions? decrease cost to developer/increase potential reward for developer
  2. Scientific Issues
    - Scientific breakthrough does not exit
    - Solution? Increase funding
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15
Q

What are the problems and solutions for technology not being accessible in developing countries?

A
  1. Cost
    - cost too high, donations
  2. Distribution
  3. Inadequate human resources
  4. Unreliable energy supply
    - Design for developing world
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16
Q

What are frugal technologies?

A

“Good enough” products that meet the basic need but at a low cost. They often look inferior, provide limited functionality, made of simpler cheaper materials.

17
Q

What are the problems and solutions for technology not being adopted in developing countries?

A
  1. Cultural resistance
    - technology conflicts with tradition
  2. Human inertia
    - reluctance to change practice
18
Q

Health Systems

A

The human resources, physical infrastructure, health care technologies, and economic resources devoted to improving the health of the population.

19
Q

What are the functions of Health Systems

A
  1. Generate human resources, physical infrastructure, and knowledge to provide health care
  2. Provide health care services
  3. Raise and pool economic resources
  4. Provide stewardship for the healthcare system
20
Q

What are the four basic models of health care?

A
  • Beveridge Model
  • Bismark Model
  • National Health Insurance Model
  • Out of Pocket Model
21
Q

What are the Global Initiatives on Health Technologies?

A

To establish a framework and identify and adapt innovative technologies

22
Q

Beveridge Model

A

Health care provided and financed by the government. Hospitals and clinics owned by government. Government controls what doctors can do and what they can charge.

23
Q

Bismarck Model

A

Insurance system financed by employers and employees through payroll deduction. Insurance must cover everybody and no profit is made.

24
Q

National Health Insurance Model

A

Uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into.

25
Q

Out-of-Pocket Model

A

You pay out-of-pocket “the rich get medical care; the poor stay sick and die”