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PHRM 849 Population Health > Midterm Exam - Lec 1-8 > Flashcards

Midterm Exam - Lec 1-8 Flashcards

1
Q

what is population health?

A

-the health outcomes of a group of individuals, including the distribution of such outcomes within the group

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2
Q

4 categories of the care continuum

A

-health promotion, wellness
-health risk management
-care coordination/advocacy
-disease case management

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3
Q

difference between population health and public health

A

public health includes critical functions of state and local public health departments such as preventing epidemics, containing environmental hazards, and encouraging healthy behaviors

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4
Q

what is the goal of comparative effectiveness research (CER)?

A

aims to produce the type of evidence that will assist all parties to make informed decisions to improve health care at both the individual and population levels

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5
Q

what are the 7 foundations of population health?

A
  1. descriptive epidemiology
  2. etiology, benefits and harms
  3. evidence-based practice
  4. implementation of health promotion and disease prevention interventions
  5. determinants of health
  6. population health informatics
  7. evaluation
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6
Q

what is population health informatics?

A

collection of pop. health data to assess pop. health, guide the provision of healthcare services and analyze health outcomes

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7
Q

which type of healthcare data is easy to obtain, standardized, and uses diagnosis codes?

a. claims data
b. electronic health record data
c. socioeconomic data
d. patient-generated health data
e. prescription and medication adherence data

A

a. claims data

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8
Q

what is the life expectancy in the US as of 2023?

A

77 years

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9
Q

four types of costs

A
  1. direct medical costs
  2. direct non-medical costs
  3. indirect costs
  4. intangible costs
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10
Q

medical costs for providing treatment

a. direct medical costs
b. direct non-medical costs
c. indirect costs
d. intangible costs

A

a. direct medical costs

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11
Q

cost of transportation to clinic, babysitter, food/lodging are examples of

a. direct medical costs
b. direct non-medical costs
c. indirect costs
d. intangible costs

A

b. direct non-medical costs

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12
Q

costs that result from loss of productivity bc of illness/death; does not involve a transfer of money

a. direct medical costs
b. direct non-medical costs
c. indirect costs
d. intangible costs

A

c. indirect costs

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13
Q

costs of pain, suffering, anxiety, or fatigue due to an illness or tx of an illness

a. direct medical costs
b. direct non-medical costs
c. indirect costs
d. intangible costs

A

d. intangible costs

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14
Q

four types of pharmacoeconomic analyses

A

cost-minimization analysis (CMA)
cost-benefit analysis (CBA)
cost-effectiveness analysis (CEA)
cost-utility analysis (CUA)

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15
Q

Used to compare costs of interventions with equivalent clinical outcomes; ex. generic vs brand name drug

a. cost-minimization analysis (CMA)
b. cost-benefit analysis (CBA)
c. cost-effectiveness analysis (CEA)
d. cost-utility analysis (CUA)

A

a. cost-minimization analysis (CMA)

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16
Q

Measures costs of interventions and outcomes in monetary units; Determines which intervention provides the best monetary benefit

a. cost-minimization analysis (CMA)
b. cost-benefit analysis (CBA)
c. cost-effectiveness analysis (CEA)
d. cost-utility analysis (CUA)

A

b. cost-benefit analysis (CBA)

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17
Q

which is the most common type of analyses?

a. cost-minimization analysis (CMA)
b. cost-benefit analysis (CBA)
c. cost-effectiveness analysis (CEA)
d. cost-utility analysis (CUA)

A

c. cost-effectiveness analysis (CEA)

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18
Q

Measures outcomes in natural health units; Determines which intervention achieves a given objective at the lowest cost

a. cost-minimization analysis (CMA)
b. cost-benefit analysis (CBA)
c. cost-effectiveness analysis (CEA)
d. cost-utility analysis (CUA)

A

c. cost-effectiveness analysis (CEA)

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19
Q

incremental cost-effectiveness ratio (ICER) formula

A

ICER = (total cost of drug A - total cost of drug B)/(outcome of drug A - outcome of drug B)

20
Q

Measures outcomes in terms of the quality of the outcome produced; Examines the cost of an intervention and the value of the outcome

a. cost-minimization analysis (CMA)
b. cost-benefit analysis (CBA)
c. cost-effectiveness analysis (CEA)
d. cost-utility analysis (CUA)

A

d. cost-utility analysis (CUA)

21
Q

most common outcome is quality-adjusted life years (QALY)

a. cost-minimization analysis (CMA)
b. cost-benefit analysis (CBA)
c. cost-effectiveness analysis (CEA)
d. cost-utility analysis (CUA)

A

d. cost-utility analysis (CUA)

22
Q

what is pharmacoepidemiology?

a. study of the use, risks, and benefits of drugs in populations
b. continual monitoring for unwanted effects and other safety- related aspects of marketed drugs
c. determining what therapeutic intervention (not just drug products) works best for a given disorder in patients likely to be seen in clinical practice
d. studies (often using randomization) that often test small practical changes that could have an impact on health outcomes

A

a. study of the use, risks, and benefits of drugs in populations

23
Q

what is pharmacovigilance?

a. study of the use, risks, and benefits of drugs in populations
b. continual monitoring for unwanted effects and other safety- related aspects of marketed drugs
c. determining what therapeutic intervention (not just drug products) works best for a given disorder in patients likely to be seen in clinical practice
d. studies (often using randomization) that often test small practical changes that could have an impact on health outcomes

A

b. continual monitoring for unwanted effects and other safety- related aspects of marketed drugs

24
Q

what is comparative effectiveness research (CER)?

a. study of the use, risks, and benefits of drugs in populations
b. continual monitoring for unwanted effects and other safety- related aspects of marketed drugs
c. determining what therapeutic intervention (not just drug products) works best for a given disorder in patients likely to be seen in clinical practice
d. studies (often using randomization) that often test small practical changes that could have an impact on health outcomes

A

c. determining what therapeutic intervention (not just drug products) works best for a given disorder in patients likely to be seen in clinical practice

25
Q

definition of pragmatic research

a. study of the use, risks, and benefits of drugs in populations
b. continual monitoring for unwanted effects and other safety- related aspects of marketed drugs
c. determining what therapeutic intervention (not just drug products) works best for a given disorder in patients likely to be seen in clinical practice
d. studies (often using randomization) that often test small practical changes that could have an impact on health outcomes

A

d. studies (often using randomization) that often test small practical changes that could have an impact on health outcomes

26
Q

true or false: pharmacoepidemiologic and pharmacovigilance studies are primarily experimental

A

false (observational)

27
Q

what is the INPC?

A

Indiana Network for Patient Care; provides > 100 separate healthcare entities providing data that can be used across Indiana

28
Q

bias related to information regarding exposure or outcome; includes measurement and/or classification error

a. information bias
b. detection bias
c. confounding by indication

A

a. information bias

29
Q

specific outcome is diagnosed preferentially in subjects exposed to the agent; e.g. may be more likely to look for an AE in someone who is exposed to a drug

a. information bias
b. detection bias
c. confounding by indication
d. selection bias

A

b. detection bias

30
Q

bias related to procedures used to select subjects/influence study participation

a. selection bias
b. referral bias
c. protopathic bias
d. prevalence bias

A

a. selection bias

31
Q

reason for encounter is related to drug treatment (e.g., when the use of the drug contributes to the diagnostic process)

a. selection bias
b. referral bias
c. protopathic bias
d. prevalence bias

A

b. referral bias

32
Q

exposure of interest is used unknowingly to treat an adverse event related to outcome/agent is used for early manifestation of a disease that has not yet been diagnosed

a. selection bias
b. referral bias
c. protopathic bias
d. prevalence bias

A

c. protopathic bias

33
Q

in pharmacoepidemiology, _______ bias occurs when the drug is initiated in response to the first symptoms of the disease which is, at this point, undiagnosed

a. information
b. detection
c. selection
d. referral
e. protopathic
f. prevalence

A

e. protopathic

34
Q

what is immortal time bias?

A

period of follow-up when, due to the exposure definition, the outcome being studied could never occur

(first discovered in heart transplant studies)

35
Q

what is the FDA Sentinel System?

A

safety program that monitors safety of FDA regulated products

36
Q

diff between efficacy and effectiveness

A

efficacy refers to whether a drug (or other tx) works in controlled settings, while effectiveness refers to whether it in fact works in the real world

37
Q

one goal of CER is to overcome _____ validity problems with traditional RCTs

A

external

38
Q

which has strictly enforced interventions, with adherence generally being monitored?

a. RCTs
b. pragmatic trial

A

a. RCTs

39
Q

what is the control in a pragmatic trial?

A

usually current standard of care (placebos are rare)

40
Q

which trials have high internal validity, but low external?

a. RCTs
b. pragmatic

A

a. RCTs

41
Q

which trials have high external validity?

a. RCTs
b. pragmatic

A

b. pragmatic

42
Q

how much does healthcare cost per person per year in the US? What % of the GNP is it?

A

> $13,000/yr/person
17% of GNP

43
Q

____ % of individuals are contacted by a collection agency for unpaid bills

A

14%

44
Q

which age group do we spend the most on for total health spending?

A

pts 65 and up

45
Q

true or false: public health is overfunded in the US healthcare system

A

false (underfunded; COVID was the “great awakening” that our public health system was not very good)

46
Q

which is the most common preventable death in 2021?

a. drug overdose
b. alcohol-induced
c. suicide

A

a. drug overdose

47
Q

give some examples of “waste” from lecture (4 of them; slide 63 of 72)

A

-unnec care
-care outside standards and guidelines
-fraud
-providers’ time due to admin duties (ex. prior authorizations)

PHRM 849 Population Health (2 decks)

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