Public Health

Question 1

How do you calculate the Number Needed to Treat?

Answer 1

100/ARR

Question 2

Define… Incidence, Prevalence, Sensitivity and Specificity

Answer 2

Incidence – the number of new cases over a period of time
Prevalence – the number of existing cases at a certain point in time
Sensitivity – the proportion of people correctly identified in screening
Specificity – the proportion of negative test results of the total number who don’t have the disease

Question 3

What is Health Needs Assessment?

Answer 3

A process used to assess the need, demand and supply of services available.

Question 4

What is a measure of quality of life?

Answer 4

QUALY – Quality Adjusted Life Years

Question 5

Attempt to describe what absolute and relative risk are and how you work them out

Answer 5

AR – the number of events out of total population, for example stroke risk in a population is 0.25 or 25%
RR – Absolute risk in a control group/absolute risk in treatment group – this allows a comparison of risk, for example a RR of 0.8 means 20% risk reduction

Question 6

What is a QUALY?

Answer 6

Quality and quantity of life lives - unit of measure

Question 7

Define economic evaluation

Answer 7

Assessment of efficiency - the comparative study of cost and effectiveness, the maximum cost and benefit

Allows assessment off the benefits of a health care intervention

Question 8

What two things make an economic evaluation?

Answer 8

Cost and effectiveness

Question 9

Give 2 types of economic evaluation

Answer 9

Cost benefit analysis
Cost utility analysis
Cost effectiveness analysis
Cost minimization analysis

Question 10

Define efficiency

Answer 10

When resources are allocated between activities in such a way as to maximise benefits for a given budget

Question 11

Identify opportunity cost

Answer 11

To spend resources on one activity means a sacrifice in terms of lost opportunity elsewhere

Question 12

Identify equity

Answer 12

Fairness and justice in distribution of cost and benefits

Question 13

What are the factors of a health economic evaluation?

Answer 13

Cost of both services
Benefits of both services
Comparison of the cost and benefit of the service and the alternative service

Question 14

What system is used to evaluation disability?

Answer 14

Disability adjusted life years

Question 15

Define efficiency for healthcare economics

Answer 15

Getting the maximum cost/health benefit outcomes from a service

Question 16

What is opportunity cost?

Answer 16

The money is spent elsewhere because it gives better benefit on another opportunity

Question 17

What is point prevalence?

Answer 17

The number of people with the disease divided by the number of people in the population in a time frame

Question 18

If an association is not causal it might be due to…?

Answer 18

Bias
Chance
Confounding
Reverse causality

Question 19

What are the components of the health transaction?

Answer 19

Person’s health needs and demands
Provider’s services that are supplied
How it is paid for

Question 20

What are some barriers to accessing healthcare?

Answer 20

Physical - disability
Cost
Geography
Education
Awareness
Time
Social factors - stigma

Question 21

What are the 3 main models for healthcare financing?

What is the main description of each?

Answer 21

Publicly funded - NHS, publicly owned, providers fixed budgets
Social insurance - compulsory sickness funds, providers contracted
Privately-funded - most providers private, some public service coverage

Question 22

Define...
Opportunity cost
Economic Efficiency
Equity
Economic Evaluation

Answer 22

Opportunity Cost - the cost of what you can’t do because resources have been allocated elsewhere

Economic Efficiency - when resources are allocated in a way to maximise benefit

Equity - not equality, giving what everyone needs so it is fair versus giving everyone the same

Question 23

Explain the difference in the structure of these case studies:
Case control
Cross Sectional
Prospective/Retrospective cohort
RCT

Answer 23

Case control - retrospective observational study, compared participants with and without the disease
Cohort - longitudinal prospective study of a random sample of population
Cross Sectional - take
Prospective/Retrospective cohort, snapshot with and without disease to find associations at single point in time
RCT - randomised with and without intervention

Question 24

Define an economic evaluation

Answer 24

A comparative study of the costs and benefits of healthcare interventions

Question 25

How do you calculate risk?

Answer 25

New cases/total at risk

Question 26

How do you calculate the prevalence ration?

Answer 26

Prevalence of outcome exposed/unexposed

Question 27

What is a DOLS?

Answer 27

Deprivation of Liberty
- when a patient has to be kept in hospital and treated against their wishes because they don’t have capacity and it is in their best interest

Question 28

What is the difference between primary, secondary and tertiary prevention?

Answer 28

Primary - trying to prevent someone getting a disease
Secondary - trying to detect a disease early to prevent it getting worse
Tertiary - trying to improve your quality of life and symptoms of a disease you already have

Question 29

If something brings a lot of benefit to the population it provides little individual benefit - this is known as…?

Answer 29

Prevention paradox

Question 30

What does PICO stand for?

Answer 30

Population
Intervention
Comparison
Outcome

Question 31

What are some points in the Bradford-Hill criteria?

Answer 31

They are used as evidence to support a causal association…

• strength
• consistency
• specificity
• temporality
• biological gradient
• plausibility

Question 32

What are the three main aspects of resource allocation?

Answer 32

• needs
• supply
• demand

Question 33

What are the different kinds of needs?

Answer 33

• felt
• expressed
• normative
• comparative

Question 34

What are the three different kinds of health needs assessment?

Answer 34

• epidemiological
• corporate
• comparative