Session 9: Resource Allocation and PROMs Flashcards
What is the impact of scarce resources on doctors?
When demand outstrips supply, we have to set priorities and allocate resources wisely.
What are the 2 forms of rationing?
Explicit and implicit
What is explicit rationing?
Using institutional procedures for systematic allocation of resources within health care system
What is implicit rationing?
Allocation of resources through individual clinical decisions without explicit criteria
What is NICE?
National Institute for Health and Care Excellence
What is NICE’s purpose?
Provides guidance on whether new or existing treatments can be recommended for use in the NHS in England
What is scarcity?
Demand outstrips supply, prioritization is inevitable
What is efficiency?
Getting the most out of limited resources
What is equity?
Extent to which distribution of resources is fair
What is effectiveness?
Extent to which an intervention produces desired outcomes
What is utility?
Value an individual places on a health state
What is opportunity cost?
Value of next best alternative use of resources or benefits foregone
What is technical efficiency?
Most efficient way of meeting a need
What is allocative efficiency?
Best way to allocate resources to achieve best possible overall outcome
What are the 4 types of economic evaluation?
- Cost minimization analysis
- Cost effectiveness analysis
- Cost benefit analysis
- Cost utility analysis
What is cost minimization analysis?
Assume outcomes to be equivalent and only think about costs
What is cost effectiveness analysis?
Used to compare treatments that have same outcome, divide cost by unit outcome.
If costs and benefits are higher for a treatment, compare the extra benefit obtained for the extra cost. Then determine if the extra benefit is worth the cost.
What is cost benefit analysis?
All inputs and outputs valued in monetary terms, which may be difficult
What is cost utility analysis?
Calculate quality of health outcomes produced or foregone - quality adjusted life year (QALY)
What does QALY determine?
Adjusts life expectancy for quality of life
How to calculate QALY?
1 year of perfect health = 1 QALY = 10 years of 0.1 health
What is one instrument used to measure quality of life?
EQ5D
What are the advantages of QALY?
Effective way to calculate benefits gained per unit cost
What are 3 disadvantages of QALY?
Doesn’t distribute resources based on need
Doesn’t assess impact on carers and family
Imperfect evidence to measure quality of life
