Resource Allocation Flashcards
What is implicit rationing?
The allocation of resources through indivdual clincial decisions without the criteria for these decisions bing explicit
What are some of the issues with implicit rationing?
Can lead to inequalities and discrimination
Open to abuse
Decsions based on perceptions of social deservingness
Doctors appear increaisngly unwilling to do it
What is explicit rationing?
Use of instutional procedures fo the systematic allocation of resources within a healthcare system, and the rationing behind the decisions are explicit
What are the advantages of explicit rationing?
Transparent, accountable,
Opportunity for debate
More clearly evidence based
More oppurtunities for equity in decision making
What are the disadvantages of explicit rationing?
Very complex, Heterogeneity of paitents and illness? Patient and professional hostility, Impact and clinical freedom Some evidence of patient distress
What are the basic concepts of health economics?
Scarcity Efficency, egauitiy, Effectiveness Utility Oppurtunity cost
What is opputunity cost?
When deciding to spend resources on a new treatment, these resources can now not be used in other treatments, and therefore the opportunity cost is the value of the next best alternative use of these resources
What is technical efficiency?
You are interested in the most efficient way of meeting a need.
What is allocative efficiency?
You are choosing between the many needs to be met
What is a economic evaluation?
A comparison of reouscre implications or benefits or alternate ways of developing healthcare, and facilitates decisions so that they are more transparent and fair
What are the different categories of costs that are involved in helathcare?
Costs of the healthcare resources, costs of the patietns time, costs associated with care giving, other costs associated with illness, economic costs bourne by the employees,
How can you measure some of the benefits of healthcare?
Impact on health status
Savings in other health resources
Improved productivity of patient or other family members
What is a cost minimisation anaylsis?
Outcomes are assumed to be equviliant, and therefore the focus is on costs, and not often relevant as the outcomes are rarely equiviliaant
What is a cost effectiveness anaylsis?
Used to compare drugs or outcomes that have a common helath outcome, and is compared in costs per unit outcome, and if costs are higher for one treatment, but benefits are too, you need to calculate how many benefits are created for the extra cost
What is a cost benefit analysis?
All inputs and outputs are viewed in monetary terms, and cal allow comparisons with interventions outside healthcare, butthere are methodological difficulties such as putting the money value on the non- monetary benefits, and willingness to pay is often used, but is also problematic
What is a cost utility analysis?
A particular type of cost effectiveness analysis, which focuses on health quality that is produced or foregone, and the most frequently used measure is a quality adjusted life year
What is a QALY?
Adjusts life expectancy for quality of life, where 1 year of perfect health is 1 QALY, assumes that this is worth 10 years of life at 0.1 health
What are some of the alternatives to QALYs?
Health year equivalents
Saved young life equvivilants
Disability adjusted life years
What are some controversies regarding the used of QUALYS?
About the values that they embody- how do you value life
Do not distrubute according to need but by benefit per unit of cost
May disadvantage common conditions
Technical problems with calculations
May not assess all dimensions of benefit
RCT evidence is not perfect
Do not assess the effects on carers or families
