everything & nothing Flashcards
(43 cards)
malaria vaccines
- RTS, S/AS01 vaccine (4 doses from ~5months of age)
- R21/Matrix-M vaccine
economics definition
economics as a discipline is concerned with choices. choices about what to do with scarce resources which have multiple uses
health economics definition
is the branch of economics concerned with issues related to the production and consumption of health and healthcare, including efficiency, effectiveness, equity, value and behaviour
economic evaluation definition
the comparative analysis of alternative courses of action in terms of both their costs and consequences
health related quality of life definition
a multi-dimensional concept that includes domains related to physical, mental, emotional, and social functioning
definition of ICER (incremental cost-effectiveness ratio)
it is a measure of cost-effectiveness of an intervention when compared to another (even if that be ‘do nothing’)
definition: patient costs
costs associated with healthcare that are borne by the patient. these are typically separated into direct medical costs, direct non-medical costs and indirect costs (lost time)
what is cost-effectiveness analysis (CEA)
costs expressed in monetary units, and effect can be any measure of health, often a natural measure of health eg premature deaths averted
CEA
costs are measured in terms of money compared to health benefits they provide eg how many premature deaths are prevented
cost-utility analysis CUA
can be considered as a ‘sub-case’ of CEA (often used interchangeably), with costs again expressed in money, but the health effect is a generic measure of health gain (eg QALY, DALY)
Cost-benefit analysis (CBA)
both costs and outcomes expressed in monetary items
ICER incremental cost effectiveness ratio
is used to summarise the relative cost-effectiveness of one health intervention compared to another (even if this is ‘do nothing’). it is calculated by dividing the incremental costs by the incremental effects
ICERs
are compared to a cost-effectiveness threshold to determine if an intervention is cost-effective ‘i.e. value for money’. when a generic measure of outcome is used (eg qaly or daly) an intervention can be compared with those made elsewhere in the system
ICER
cost of int A - cost of int B divided by effect of int A - effect of int B
QALY & DALY
are generic measures of health, which combine both morbidity and mortality in a single measure. such measures are necessary to allow the comparison of interventions across the health system, essential for the fair allocation of health resources
calculation of QALYs & DALYs
- health is characterized into individual defined ‘health states’
- each state is assigned a numeric value, quantifying the experience of living state
- estimates of life expectancy with and without the condition(s) are then factored in Dalys Qalys
DALY - disability-adjusted life-year
- measure of health lost/disease burden- i.e. dalys are undesirable
- ‘off-the-shelf’ disability weights (0-1) for different diseases/conditions- comprehensive list published by ‘GBD’
- much more commonly used in LMICs
- daly = years of life lost due to mortality (yll) + years lost due to disability (yld)
DALY =
years of life lost due to mortality (yll) + years lost due to disability (yld)
QALY - Quality adjusted life-year
- measure of health (i.e. qalys are desirable)
- perfect health for one year = ‘half health’ for 2 years = 1 qaly
- individual value sets for specific countries
- NICE uses them in UK
- vast majority of QALY studies in upper-middle-income / high income countries
Definition: sex
refers to biological differences between men & women
Definition: Gender
refers to those characteristics of women and men that are socially and culturally constructed- women’s and men’s different behavior, roles, expectations and responsibilities in a given cultural context
Gender is
socially constructed
unequal and hierarchical
ideological
institutional
relational
gender inequities
= differences between women and men’s situation which are avoidable or unfair e.g. in:
- allocation of health resources
- access to/utilisation of healthcare
- health status
Inequity vs inequality
while inequality describes differences or disparities between individuals or groups, inequity emphasizes the unfairness or injustice inherent in these disparities, often resulting from systemic factors or social structures that disadvantage certain groups
