Public Health Flashcards
How do you calculate the Number Needed to Treat?
100/ARR
Define… Incidence, Prevalence, Sensitivity and Specificity
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
What is Health Needs Assessment?
A process used to assess the need, demand and supply of services available.
What is a measure of quality of life?
QUALY – Quality Adjusted Life Years
Attempt to describe what absolute and relative risk are and how you work them out
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
What is a QUALY?
Quality and quantity of life lives - unit of measure
Define economic evaluation
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
What two things make an economic evaluation?
Cost and effectiveness
Give 2 types of economic evaluation
Cost benefit analysis
Cost utility analysis
Cost effectiveness analysis
Cost minimization analysis
Define efficiency
When resources are allocated between activities in such a way as to maximise benefits for a given budget
Identify opportunity cost
To spend resources on one activity means a sacrifice in terms of lost opportunity elsewhere
Identify equity
Fairness and justice in distribution of cost and benefits
What are the factors of a health economic evaluation?
Cost of both services
Benefits of both services
Comparison of the cost and benefit of the service and the alternative service
What system is used to evaluation disability?
Disability adjusted life years
Define efficiency for healthcare economics
Getting the maximum cost/health benefit outcomes from a service
What is opportunity cost?
The money is spent elsewhere because it gives better benefit on another opportunity
What is point prevalence?
The number of people with the disease divided by the number of people in the population in a time frame
If an association is not causal it might be due to…?
Bias
Chance
Confounding
Reverse causality
What are the components of the health transaction?
Person’s health needs and demands
Provider’s services that are supplied
How it is paid for
What are some barriers to accessing healthcare?
Physical - disability Cost Geography Education Awareness Time Social factors - stigma
What are the 3 main models for healthcare financing?
What is the main description of each?
Publicly funded - NHS, publicly owned, providers fixed budgets
Social insurance - compulsory sickness funds, providers contracted
Privately-funded - most providers private, some public service coverage
Define... Opportunity cost Economic Efficiency Equity Economic Evaluation
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
Explain the difference in the structure of these case studies: Case control Cross Sectional Prospective/Retrospective cohort RCT
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
Define an economic evaluation
A comparative study of the costs and benefits of healthcare interventions
How do you calculate risk?
New cases/total at risk
How do you calculate the prevalence ration?
Prevalence of outcome exposed/unexposed
What is a DOLS?
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
What is the difference between primary, secondary and tertiary prevention?
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
If something brings a lot of benefit to the population it provides little individual benefit - this is known as…?
Prevention paradox
What does PICO stand for?
Population
Intervention
Comparison
Outcome
What are some points in the Bradford-Hill criteria?
They are used as evidence to support a causal association…
- strength
- consistency
- specificity
- temporality
- biological gradient
- plausibility
What are the three main aspects of resource allocation?
- needs
- supply
- demand
What are the different kinds of needs?
- felt
- expressed
- normative
- comparative
What are the three different kinds of health needs assessment?
- epidemiological
- corporate
- comparative
