Resource Allocation Flashcards
What factors are leading to increased demand of NHS resources?
Increasing ageing population
Increased amount of chronic diseases
What is opportunity cost in healthcare?
Once you’ve used a resource in one way, you no longer want to use it another way.
Cost is viewed as sacrifice rather than financial expenditure
O.C is measured in benefits given up
What are two forms of rationing?
Explicit and implicit
What is explicit rationing?
Based on defined rules if entitlement. The use of institutional procedures for the systemic allocation of resources
What are the advantages and disadvantages of explicit rationing?
-Advantages: transparent and accountable, evidence based, open for debate.
-Disadvantages: complex, there’s individuality in each patient and illness, impact on clinical freedom.
What is implicit rationing?
Allocation of resources through individual clinical decisions without those decisions being explicit.
What are advantages and disadvantages of implicit rationing?
Can lead to discrimination, open to abuse, decisions could be based of social deservingness.
What are some costs and benefits to be considered when making decisions about healthcare?
-Costs of healthcare service
-Costs of patient’s time
-B- impact on health status
-Savings in other resources
-Increasing productivity
What is cost minimisation analysis?
Focus on costs, not relevant as outcomes rarely equivalent.
E.g - all prostheses for hip replacement improve mobility equally, choose cheapest one
What is cost effectiveness analysis?
Used to compare interventions which have common health outcome, compared in terms of cost per unit outcome.
Is extra benefit worth cost?
What is cost benefit analysis?
Value everything in monetary terms, allows comparison with external (not healthcare) interventions, methodological difficulties
difficulty labelling non-monetary benefits, lives saved
What is cost utility analysis?
Type of cost effectiveness analysis, focuses on quality of health produced/negated, measured as QALY
What is QALY?
Measures survival and quality of life
1 QALY= 1 year of perfect health (assume 1yr perfect health = 10yrs w 0.1 perfect health)
1 QALY= 2 yrs of 50% quality of life for 1 person
1 QALY= 6 months healthy for 2 people
Quality of life x quantity of life = QALY
What are the advantages and disadvantages of QALYs?
-Advantages: prevents large implicit rationing, explicit rationing (more transparent and centralised)
-Disadvantages: doesn’t distribute resources according to needs but benefits gained per cost, disadvantages common conditions, doesn’t assess impact of carers or family.
What is health related quality of life (HRQoL)?
Impact of treatments and disease as perceived by patient.
