Module 3 Lecture 23

Question 1

Why do we need to prioritise in health

Answer 1

Not enough money at the moment to fund all the health problems we would like to

Question 2

Evidence Based Processing steps

Answer 2

Descriptive, Explanatory and Evaluative

Question 3

Descriptive

Answer 3

• Where are we now? Where have we come from? Where are we going? - Trends over time
• Who is most/least affected
• Defining the problem

Question 4

Explanatory

Answer 4

What are the determinants? What are the risks?
Why are we getting worse/better?
Why are populations different?

Question 5

Epidemiological measures used in prioritisation

Answer 5

• Age at death and premature mortality (Years of potential Life Lost to death - YLL)
• Time lived with disability (Disability Adjusted Life Years - DALYs)
• Population Attributable Risk (PAR)

Question 6

Risk Difference/ Attributable Risk

Answer 6

The amount of “extra” disease attributable to a particular risk factor in the exposed group
EGO - CGO

Question 7

Population Attributable Risk

Answer 7

The amount of “extra” disease attributable to a particular risk factor in a particular population (If the association is causal this is the amount of disease we could prevent if we removed that particular risk factor from the population)
EITHER Incidence in total population (PGO) - Incidence in unexposed population (CGO)
OR RD x Prevelance of exposure in the population

Question 8

Evaluative

Answer 8

• What can improve health outcomes (and in whom?)
• How well can the problem be solved
  + Target population
  + Expected number in population who will be reached
  + Evidence of effectiveness (based on known success rates in literature)
  + Cost

Question 9

Economic Feasibility

Answer 9

• Does it make economic sense to address the problem?

- Are there economic consequences if not carried out

Question 10

Opportunity Cost

Answer 10

The health benefits that could have been achieved had the money been spent on the next best alternative intervention or healthcare programme e.g. Tobacco use versus Obesity

Question 11

Acceptability

Answer 11

• Will the community and/or target population accept the problem being addressed
• Competing interests

Question 12

Prioritisation

Answer 12

What do patients want

• Access to necessary healthcare
• Confidence in the health care system
• Fair treatment
• Culturally Appropriate
• Good information about their options

Question 13

When prioritising what also has to be taken into account along with evidence based processing

Answer 13

• Community expectations and values
• Public attitudes
• Human rights and social justice