Lecture 7 - Intro To Healthcare Systems In UK Flashcards
What is the definition of Health systems?
All activities whose primary purpose is to promote, restore and maintain health
What are the different types of healthcare financing?
Out of pocket Payments
Private health insurance
Social health insurance
Tax based financing
What are out of pocket payments?
Direct payments by patients for medical care
There’s no reimbursement by insurers or government
What are some examples of out of pocket payments?
Paying for medication
Consultations with doctors
What is the advantage of out of pocket payments?
Contains health service demand
What is the advantage of out of pocket payments?
Contains health service demand
What are the disadvantages of out of pocket payments?
People may under use health services
EXACERBATES HEALTH INEQUALITIES
Serious illness could result in catastrophic health expenditures
Costs those on lowest incomes proportionally more
What is the principle of private health insurance?
Individuals contribute to a fund by paying voluntary premiums in advance to an insurance company
The costs of healthcare are then covered when required
What are the advantages of private health insurance?
Protection against catastrophic expenditure (pool the risk)
Patients have a choice of insurer and competition may drive up standards of care
Reduces burdened Ono public finances
What are the disadvantages of private health insurance?
Costs those on lowest iiincomes proportionally more
EXACERBATES HEALTH INEQUALITIES
Moral hazard (over consumption and over provision of health care)
Adverse selection (those at lower risk will not purchase)
What is social health insurance?
Where employers and employees contribute to a fund (employers contribute a proportion of their salary and employers match it)
Type of insurance system
Government pays contributions for those out of work
What are the advantages of social health insurance?
Protection against catastrophic expenditure
UNIVERSAL coverage through government contributions
Access based on need
Social insurance funds can. Be kept separate from other government funds
What are the disadvantages of social health insurance?
High adminsitration costs (reimbursement)
May be opt out for higher earners
What is taxation for health care funding??
Where health care is funded through general taxation (NHS) provided mostly by state controlled privders and doctors
What are the advantages of taxation method of funding healthcare?
UNIVERSAL COVERAGE
Access based on needs
Fewer inequalities
Lowers administration costs
Controls on spending prioritisation
What are the disadvantes of taxation in healthcare funding?
Healthcare budgets less predictable (dependant on government funding)
Moral hazard (overuse of healthcare)
Less choice of providers
How many NHS boards are in Scotland?
14
How many local health boards are in wales?
7
How many health and social care trusts are in Northern Ireland?
5
What are integrated care systems?
Partnerships that bring together providers and commissioners of NHS services across a geographical area
What is the purpose of integrated care systems?
Plan health and care services to meet the needs of their population
Integrate are across different organisations joining up hospital and commmunity based services,s
What are the advantages of integrated care systems?
Focus on. Collaboration not competition
Improving care for people with long term conditions
Potential to tackle inequalities
What is the responsibility of local authorities under public health England?
Improving h earth of their local population and for public health services including most sexual health services and services aimed at reducing drug and alcohol misuse
What is clinical prioritisation and resource allocation dependant on?
What’s the criteria?
Burden of disease
Clinical effectiveness of the interventions
Cost effectiveness
Equity
Needs clear framework
Explicit processes for rationing
Process for appeals audits and evaluation
Why may there be variation in services provided by a region?
Different eligibility criteria between different ICBs leads to different proportion of NHS funding which is allocated
What are individual funding requests?
For patients who fall outside what is currently commissioned and have genuinely exceptional circumstances
What is the panel checklist?
Essentially validates whether a patients individual funding request is valid
What is exceptionality?
Patient is ina different clinical condition when compared to the typical patient population with the same condition
AND
Because of the difference patient is likely to receive additional clinical benefit from treatment
