Class 7 - Health care economics

Question 1

Define health care economics

Answer 1

the study of supply and demand of resources and it’s affect on the allocation of healthcare resources in an economic system

Question 2

What are the concept categories within health care economics

Answer 2

• availability of resources
• health care financing
• utilization of resources

Question 3

poor resource access can result in what?

Answer 3

disparities

Question 4

significant differences (disparities) are seen among populations based on:

Answer 4

• race and ethnicity
• socioeconomic status
• geographic regions

Question 5

What resources are included for the delivery of high-quality services

Answer 5

• people, time, and talent
• land, buildings, and equipment
• knowledge of how to combine these resources

Question 6

What is utilization of resources

Answer 6

• the concern with efficiency and distribution
• link to access
• is greatest among individuals with multimorbid chronic conditions

Question 7

What are the attributes of health care economics

Answer 7

• cost effectiveness
• efficiency
• value

Question 8

Health care economics attributes, cost effectiveness

Answer 8

• efficient and equitable decisions are made about the allocation of resources
• A combination of the seller’s production costs plus an additional increment that represents the seller’s profit

Question 9

Health care economics attributes, efficiency

Answer 9

• determined by how resources are used
• can be thought of as avoiding waste (including waste of equipment, supplies, and people) or as using healthcare resources to get the best value for the money

Question 10

Health care economics attributes, value

Answer 10

• health outcomes achieved per dollar spent
• remains largely unmeasured and misunderstood

Question 11

HCE attributes, relations

Answer 11

↑ value + not cost efficient = ↓ efficiency = less sustainable

↑ value + cost efficient = ↑ efficiency

Question 12

Why should nurses care about health care economics

Answer 12

• Nurses often learn issues that directly affect their patients and discharge (insufficient resources to pay out-of-pocket costs or to purchase medications)
• constant concern for cheating efficiencies in practice, reducing unnecessary waste, and working together to reduce the costs of care

Question 13

Where does money come from to pay for health care in Canada

Answer 13

tax and equalization payments

Question 14

Evolution of healthcare system, pre WWII

Answer 14

• privately delivered and funded
• hospital were avoided
• government involved in sanitation and quarantine (infectious disease)
• physicians had high social and financial standing
• Great Depression: unemployment rate 30%

Question 15

Evolution of healthcare system, post WWII

Answer 15

• 1947, Sask did province wide universal hospital care plan
• 1957, Hospital Insurance and Diagnostic Services Act involved diagnostic and hospital services (50/50 cost sharing model)
• 1961, all 10 provinces participates in Hospital Insurance Diagnostic Plan Act
• 1962, Sask Medical Insurance Act - universal, provincial insurance plan to all Sask residents
• Sask docs strike, 23 days
• 1966 Federal government passes Medical Care Act - feds pay 1/2 province costs

Question 16

Who is considered father of Canadian medicare

Answer 16

Tommy Douglas

Question 17

Where does money come from for health care?

Answer 17

• federal government to provinces
• Canada health act
• MB (provincial) budget
• private insurance

Question 18

Federal government to provinces

Answer 18

• equalization payments: fed transfer ‘equal’ amount to each province
• Canada social transfer (welfare): all province get it - must be spent on HC/ed & comply w/ CHA
• Canada health transfer: Canada health act

Question 19

What are the five principles of the Canada Health Act

Answer 19

• public administration: public get a ‘watch dog’
• comprehensive: all health services (physician services, hospital care, medically required dental procedure)
• universality: all insured (citizen + PR)
• portability: service is covered if traveling
• accessibility

Question 20

What are the highest spending in MB provincial budget

Answer 20

health and education

Question 21

What can be done if health spending continues to increase

Answer 21

• move funds from one part of budget to another
• reduce health spending
• raise taxes :(

Question 22

How many Canadians have some form of private health insurance

Answer 22

65%

Question 23

How many Canadians have a third-party insurance plan/private pay situation

Answer 23

30%

Question 24

What is considered ‘extra service cost’ in MB? What is paid out of pocket

Answer 24

• eye glasses/exams
• dental (if >3)
• drugs
• physio, OT, massage therapy
• psychologist, counsellor

Question 25

Provide examples of which aspects of health care are NOT covered by govy

Answer 25

- nutrition - mental health - aging population - co-morbidities

Question 26

What are the types of resource distribution with health care services

Answer 26

- basic framework of services - service classification

Question 27

what are the types of services within Basic Frameworks of Services

Answer 27

- primary health care services: docs + nurses - secondary health services: referred to specialist, long-term care, community - additional health care services: drugs, IVF, vision, dental, therapy, insurance

Question 28

What are the types of services with Service Classification

Answer 28

- public health services/prevention services: promote health, prevent disease, control infect. disease (vaccine, ambulaotry care) - community care services - hospital services

Question 29

What examples of resources distribution is currently present in MB

Answer 29

- Regional Health Authority (5 total) - Cancer Care - Addictions Foundations - Diagnostic services - Cadham Lab - Selkirk Mental Health Centre

Question 30

Provide example os cost conscious nursing practice

Answer 30

- meeting patient needs rather than provider needs - knowing and controlling costs - evaluating cost effectiveness of new tech - predicting and using nursing resources efficiently - using research to evaluate standard nursing practices - leaders and nurse managers ideally, would staff to avoid OT - reduce waste - EIP = better outcomes

Question 31

What is the link between health care economics and nursing leadership

Answer 31

nurses are a major workforce within healthcare organizations and fulfill multiple roles

Question 32

What 3 aspects make up healthcare costs

Answer 32

costs = price x utilization Costs: a function of the prices in the utilization rates of healthcare services - Price: the rate that health care providers set for the services they deliver, such as hospital rate or physician fee as well as the unit prices of medication and supplies - Utilization: quantity or volume of services provided, such as the number of diagnostic tests provided or the number of patient visits

Question 33

What causes health care costs to rise

Answer 33

- price inflation in meds and supplies - growing labour costs - Lack of appropriateness or effectiveness of some type of care - consumer beliefs and attitudes - healthcare financing - pharmaceutical usage - changing population demographics and disease patterns

Question 34

What are the top reasons for hospital admins, according to CIHI (2018)

Answer 34

- child birth (most common) - bronchitis - acute MI - pneumonia - HF - osteoarthritis - mood disorders

Question 35

Define health care disparities

Answer 35

the differences or gaps in care experienced by one population compared with another

Question 36

What does the cycle of disparities look like

Answer 36

- access to care - provider bias - poor communication - poor health literacy - other factors

Question 37

Example of groups at risk of disparities

Answer 37

r/t SDoH - poor structural SDoH = increase risk - minority groups - rural residents - women and children - people with disabilities