PH Flashcards
[PP]
Define impairment and disability.
Impairment:
- any loss or abnormality of psychological, physiological or anatomical structure or function
Disability:
- any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being
= activity limitation + participation restrictions
[PP]
Mr. Poon, a 68-year-old male, had osteoarthritis of the knee, leading to reduced mobility.
Give three situations that LIKELY lead to disability in Mr. Poon’s case.
- Lack of public transportation (e.g. the bus stop or MTR station is too far away from home)
- Lack of knowledge of how to build or maintain a therapeutic home environment such as installing grab bars
- Lack of access for physiotherapy
[PP]
Define activity limitation.
Difficult for a person with impairment to do certain activities
e.g. seeing, hearing, walking, problem solving
[PP]
Define participation restriction.
Difficulty for a person with impairment to interact with the world around them
e.g. working, social and recreational activities, accessing health care & preventive services
[PP]
Mr. Lam, a 67-year-old retired male living alone in a small apartment at the 3rd floor of an old building without a lift in a small village in the New Territories, was diagnosed with severe knee osteoarthritis.
Give one example that may LIKELY lead to Mr. Lams activity limitation.
Lack of wheelchair => unable to walk
[PP]
Mr. Lam, a 67-year-old retired male living alone in a small apartment at the 3rd floor of an old building without a lift in a small village in the New Territories, was diagnosed with severe knee osteoarthritis.
Give one example that may LIKELY lead to Mr. Lam’s participation restriction.
Lack of lift => unable to leave his building to join social & recreational activities
[PP]
A 34-year-old male is recently diagnosed with rheumatoid arthritis. His doctor is planning to teach him some self-management strategies to live with the disease and cope with the daily symptoms. What is the BEST way to facilitate him to adhere to the self-management plan?
A. To ask him how much he wants to be involved in planning the care plan
B. To emphasise that many patients with rheumatoid arthritis cope well with the illness and symptoms
C. To provide a comfortable environment so personal issues can be freely discussed
D. To reassure him that you are the expert in treating rheumatoid arthritis
A
X reassurance
[PP]
Ms. Chan, 56-year-old female, has tennis elbow (lateral epicondylitis) and has trouble when twisting her forearm, e.g. turning a door handle or opening a jar. Under what circumstances will her condition become a disability?
A. Lack of assistive tools and devices
B. Lack of awareness of the potential long-term health consequences
C. Lack of communication aids
D. Lack of social support
A
[PP]
Health Economics
A. Direct costs
B. Efficiency
C. Equity
D. Indirect costs
E. Intangible resources
F. Need-Demand-Supply
G. Opportunity costs
H. Scarcity of resources
I. Tangible resources
From each of the following descriptions, select the MOST RELEVANT economic concept / principle from the list of options above.
Not enough public health resources to cover two treatment options
H
[PP]
Health Economics
A. Direct costs
B. Efficiency
C. Equity
D. Indirect costs
E. Intangible resources
F. Need-Demand-Supply
G. Opportunity costs
H. Scarcity of resources
I. Tangible resources
From each of the following descriptions, select the MOST RELEVANT economic concept / principle from the list of options above.
Maximising the benefits from the use of public health resources
B
[PP]
Health Economics
A. Direct costs
B. Efficiency
C. Equity
D. Indirect costs
E. Intangible resources
F. Need-Demand-Supply
G. Opportunity costs
H. Scarcity of resources
I. Tangible resources
From each of the following descriptions, select the MOST RELEVANT economic concept / principle from the list of options above.
Fairness in health care provision
C
[PP, formative]
Calculate the QALYs for a health condition A and B:
The health condition A had a total of 48 years of life lived in perfect health, versus a disease B caused a 40% reduction of health living till the age of 80. Assume that both health conditions had an onset at birth.
QALY (A)
= 48 * 1.0
= 48 QALYs
QALY (B)
= 80 * 0.6
= 48 QALYs
[PP, formative]
Name two factors that may affect quality of life of a patient.
Bio: pain
Psycho: mood, self-care ability
Social: social activities, household activities, paid employment
[PP, formative]
What is the main advantage of QALY over mortality rate as a measure of disease burden?
Reflect also morbidity / suffering / quality of life (QOL) in addition to mortality
Adjust life years for QOL
[PP, formative]
A cost analysis represents economic evaluation techniques that involves the systematic collection, categorisation and analysis of program intervention costs or costs or illness. When determining the cost of low back pain (LBP), costs may be categorised as direct and indirect.
Provide three examples of direct costs that patients may incur during the treatment for LBP.
Costs of medicine, diagnostic test, physiotherapy
[PP, formative]
A cost analysis represents economic evaluation techniques that involves the systematic collection, categorisation and analysis of program intervention costs or costs or illness. When determining the cost of low back pain (LBP), costs may be categorised as direct and indirect.
Provide two examples of indirect costs patients may incur during the treatment for LBP.
Costs of travelling, forfeited salary
[PP]
Composite measures quantify the disease burden. Which composite measure is calculated as the number of years of healthy list that is forgone due to death or suffering?
A. Disability-Adjusted Life Expectancy (DALE)
B. Disability-Adjusted Life Year (DALY)
C. Healthy Life Year (HeaLY)
D. Quality-Adjusted Life Year (QALY)
B
DALY = YLLs + YLDs
DALE = #years a newborn can live free of disease
HeaLY = #remaining years that a person is expected to live at a certain age without the disability
[PP]
Major contributing diseases to global disability-adjusted life years (DALYs) vary widely in different age groups. For children aged between 1-10, what kind of disease represents the major contributor to global DALY?
A. Gastroenteritis
B. Nutritional deficiencies
C. Parasitic infection
D. Unintentional injuries
A
Nutritional deficiencies: <1 y/o
[PP]
Musculoskeletal injuries represent a disease burden locally and globally. Which of the following will you use to measure the burden of disease for patients with less-than-ideal health condition after musculoskeletal injury?
A. Cox regression analysis
B. Disability-Adjusted Life Year (DALY)
C. Morbidity of each specific musculoskeletal injury
D. Years Lost due to Disability (YLD)
D
[PP]
Give one example of the fund that may help to cover costs of drugs listed in the HA Drug Formulary.
The Samaritan Fund 撒瑪利亞基金
The Community Care Fund (CCF) 關愛基金
[PP]
Explain the purpose of the HA targeted subsidy programmes for patients (1 mark) and give an example of the Drug Formulary category to which this programme is applicable. (1 mark)
Ensure no one will be denied adequate healthcare
Subsidy for patients who have financial difficulties when acquiring drugs that are clinically proven to be effective, but are very expensive
Example: Self-financed Items (SFIs) with safety net
E.g.
1. Cytotoxic drugs
2. Hormone antagonists in malignant diseases
3. Drugs for blood disorder
4. Drugs affecting the immune response
[PP]
The Hospital Authority (HA) in Hong Kong implemented the Drug Formulary as part of its strategy to mitigate drug-related costs for both the patients and HA.
Define cost-effectiveness (1 mark) and explain why the principles of cost-effectiveness are important for the HA Drug Formulary. (1 mark)
- Achieving benefit with low cost
- Ensure most efficient use of scarce, limited healthcare resources
- They are allocated in a way that maximises the overall benefit to patients and the healthcare system
[PP]
An economic analysis of the new drug listed in the DF “Special category” shows that the cost per one QALY (Quality Adjusted Life Years) is estimated to be less than the cost-effectiveness threshold. What type of economic evaluation uses QALY as the unit of measurement?
Cost-utility analysis
[PP]
Drugs listed in the Hong Kong Hospital Authority (HA) Drug Formulary (DF) are categorised into four groups.
A haematology specialist in the HA clinic would like to prescribe to a patient with a specific haematology condition a new drug listed in the DF’s “Special category”. Advise how much this patient will need to pay for this drug. (2 marks)
- The patient will pay standard fees as long as his clinical conditions meet the drug’s specified conditions
- if not he will need to self-finance the drug
