PASS Resource Allocation And Education Flashcards
Priority setting
Describes decisions about the allocation of resources between the competing claims of different services, different patient groups or different elements of care
What are the types of rationing?
Explicit
Implicit
What does QALY stand for?
Quality of adjusted life years
What would 1 QALY be equivalent to:
- 1 year of perfect health
- 10 years of … perfect health
- 2 years at … perfect health
- 10 years of 0.1 perfect health
- 2 years of 0.5 perfect health
A man diagnosed with cancer has:
- 1 year of life without treatment at 0.8 perfect health
OR
- 4 years of life with treatment at 0.2 perfect health
What effect does treatment have on the QALY?
- without: 1 x 0.8 = 0.8 QALY
- with: 4 x 0.2 = 0.8 QALYs
- no gain of QALYs with treatment
What are problems with using QALYs?
- controversy about values
- do not distribute resources according to need but to benefits gained per unit cost
- calculation problems
- do not assess impact on family
What are PROs?
Patient reported outcomes
- any report of the status of a patients health condition that comes directly from the patient without interpretation of the patients response by a clinician
What is PROMs?
patient reported outcome measures
- the tool or instruments used to measure PROs
- indications of the quality of care delivered to patients
What are the importance of PROs?
- can be used to calculate QALYs
- aid clinical trials
- increased conditions when aim is management not curing
- patient centred care
- improve outcomes in clinical practice
Two current PROMs programmes in England
Hip + knee replacement
What are the types of PROMs?
Generic
Specific
Advantages + disadvantages of generic PROMs
advantages:
- used for a range of health problems
- enable comparisons
- can assess health of populations
disadvantages:
- less detailed
- loss of relevance
- less acceptable to patients
Advantages + disadvantages of specific PROMs
Advantages:
- relevant
- sensitive to chance
- acceptable to patients
disadvantages:
- cant be used for people who dont have the disease
- limited comparison
Properties of PROMs
Reliability
Validity
Define reliability
Is the instrument accurate over time + internally consistent?
