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BMS3052 > WEEK 3 HEALTH ECONOMICS > Flashcards

WEEK 3 HEALTH ECONOMICS Flashcards

1
Q

What are the three main sources of funding in the health services for Australia?

A
  1. Australian government
  2. State and territory governments
  3. Private
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2
Q

What are two key challenges for healthcare in Australia?

A
  1. Expense and affordability

2. Rising costs, driven by both volume (ageing population) and expensive technology

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3
Q

What are the three future goals for Australian based healthcare?

A
  • Increased safety, quality and efficacy
  • Patient-centred healthcare
  • Value based healthcare
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4
Q

What is an example of how patient centered healthcare could improve?

A
  • Cutting wait times at a GP
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5
Q

What are three questions asked when it comes to evidence based practice?

A
  1. Can it work? (the theory- even if it works in a lab doesn’t mean it works in the real world)
  2. Does it work (effectiveness in the real world)
  3. It is worth it? (Cost effectiveness)
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6
Q

What is the evidence application if something can work (efficacy)?

A
  • Usually goes through regulatory approval based on evidence from clinical trials and systematic reviews
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7
Q

What is the evidence application if something actually DOES work (effectiveness)?

A
  • Goes into the clinical practice as it is based on clinical guidelines from systematic reviews (including CTs)
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8
Q

What is the evidence application if something is worth it? (cost effectiveness)

A
  • Goes into health policy and is formed from various methods including pragmatic trials ans systematic reviews
  • Looks at the cost utility and data, and a health technology assessment.
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9
Q

What do pragmatic trials do?

A
  • They evaluate the effectiveness of interventions in real life situations
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10
Q

What was the purpose and outcome of the ASPREE trial?

A

Aim was to determine whether low dose asprin can make a difference in terms of health versus adverse events (cardiovascular events)

  • Outcome was that Asprin was not different between placebo and intervention groups
  • Resulted in increased risk of bleeding. The benefits did not outweigh the risks.
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11
Q

What are the two types of efficiency in healthcare?

A
  1. Alloative effciency

2. Technical efficiency

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12
Q

What is allocative efficiency?

A
  • Efficient distribution of available resources

- Considers opportunity costs

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13
Q

Does alocative efficiency consider opportunity costs?

A
  • YES
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14
Q

What is technical efficiency?

A
  • Efficient management of single condition

- Considers cost effectiveness (narrow set of conditions)

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15
Q

Does technical efficiency consider cost effectiveness?

A
  • YES
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16
Q

What are the three different types of health economic analyses?

A
  1. Cost benefit analysis.
  2. Cost-effectiveness analysis
  3. Cost-utility analysis
17
Q

What is involved in cost benefit analysis?

A
  • Net costs
18
Q

What is involved in cost-effectiveness analysis?

A

Net costs/net change in years of life.

19
Q

What is involved in cost-utility analysis?

A

Net costs/net change in QALYs

20
Q

What can you use the cost-effectiveness plane to compare?

A
  • An intervention versus a comparator
21
Q

What can the net positive costs be based on in terms of the cost effectiveness plane?

A
  • Single entity- e.g. hospital, insurer
  • State funded health services
  • Entire health system
  • Societal (difficult to measure)
22
Q

What can the net health gain be based on in terms of the cost effectiveness plane?

A
  • Years of life lived
  • QALYs lived
  • Other
23
Q

Are QALYs (Quality Adjusted Life Years) subjective?

A
  • They can be, but still used
24
Q

If someone has lived for 1 year with a disease, and the utility weight= 0.8, then what is their QALY?

A
  • Their QALY= 1* 0.8= 0.8

- So 1 year lived with the disease= 0.8 years lived WITHOUT the disease

25
Q

What is the ICER in terms of the cost effectiveness plane?

A
  • Incremental cost effectiveness ratio

- The ratio is: Net cost/ net health effect

26
Q

What does ‘dominated’ on the cost effectiveness plane mean?

A
  • It means that there are high net positive costs and an overall net health loss of the intervention
  • This is NOT good
27
Q

What does ‘dominant’ mean in terms of the cost effectiveness plane and what are examples?

A
  • There is a net health gain and net negative cost which means that it is cost saving
  • This is the best of both worlds
  • Examples are vaccines, life saving surgery or chemo, and anti smoking cessation
28
Q

What is something that many people need to consider with new biologicals compared to those other medications already on the market?

A
  • They need to consider the cost effectiveness of them
  • Those already on the market may do the job just as well and be cheaper than those new ones
  • Also need to consider the side effects
29
Q

What is value based healthcare?

A
  • Only reimbursing companies if they achieve a successful outcome
  • So if the patient did not show the desired outcome that helped them, they should not be reimbursed
  • This encourages good practice and value
30
Q

Is value based healthcare occurring now?

A
  • NO
  • The opposite is occurring
  • This leads to over-servicing –> high service but doesn’t achieve good outcomes for the patients
  • This will take A LONG TIME to change
31
Q

What is the ‘formula’ for value based healthcare?

A
  • Value= Health outcomes that matter to patients/ costs of delivering the outcomes

BMS3052 (14 decks)

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