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Didactic Exam 1 > Gionfriddo Material > Flashcards

Gionfriddo Material Flashcards

1
Q

What is value based care?

A

A health system that provides better care, spends dollars wisely and has healthier people

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2
Q

What are 3 focus areas of value based care?

A
  1. Incentives
  2. Care delivery
  3. Information
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3
Q

What are 3 positive outcomes for the value based model?

A
  1. Economic
  2. Clinical
  3. Humanistic
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4
Q

What does value equal?

A

Quality/ Cost

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5
Q

What are the 6 domains of quality?

A
  1. Safety
  2. Effectiveness
  3. Patient-centeredness
  4. Timeliness
  5. Efficiency
  6. Equity
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6
Q

What domain of quality avoids injuries which may rise from the process of care?

A

Safety

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7
Q

What domain of quality provides services based on scientific knowledge to all who could benefit and refrain from providing services to those not likely to benefit?

A

Effectiveness

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8
Q

What domain of quality provides care that is respectful of and responsive to Individual patient preferences, needs, values, and ensure that patient value guides all decisions?

A

Patient-centeredness

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9
Q

What domain of quality reduces wait times and harmful delays for both who receive and give care?

A

Timeliness

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10
Q

What domain of quality avoids waste, in part waste of equipment, supplies, ideas, and energy?

A

Efficiency

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11
Q

What domain of quality provides care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, or socioeconomic status?

A

Equity

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12
Q

What is the triple aim of population health?

A
  1. Population health
  2. Experience of Care
  3. Per capita cost
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13
Q

Identifies high utilizers who may benefit from services aimed at reducing utilization

A

Hot spotting

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14
Q

Identifies groups which may benefit from access to services

A

Cold spotting

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15
Q

Identifies groups for targeted services

A

Segmentation

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16
Q

Identifies potential trends

A

Forecasting

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17
Q

Population health is the distribution of ________ within a population

A

Health outcomes

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18
Q

Population health is the distribution of ______ that influence that distribution

A

Determinants

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19
Q

Population health is the distribution of _________ that affect the determinants.

A

Policies and Interventions

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20
Q

What are the two broad categories of cost to consider when developing a service?

A
  1. Personnel
  2. Non- personnel
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21
Q

What type of cost considers accounting for regular cost of living adjustments as well bonuses or incentives for recruitment and retention?

A

Personnel

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22
Q

What type of cost should consider start up and maintenance cost of equipment, all relevant costs related to space, training/licensing/certificate costs, and costs for miscellaneous office supplies?

A

Non-personnel

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23
Q

Non-personnel costs can ______ over time and can be _____.

A

Increase; unpredictable

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24
Q

What can income be derived from? 2

A
  1. Direct billing
  2. Indirect benefits
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25
Q

What 3 things are involved in direct billing?

A
  1. Patients
  2. Insurance
  3. Contract
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26
Q

Indirect benefits can occur from direct sales of other ______.

A

Front-end items

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27
Q

Indirect benefits can do what for clinical services for other professionals?

A

Free up time

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28
Q

Indirect benefits can include ______ and ______ _______ of other clinical services

A

Awareness; potential provision

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29
Q

Indirect benefits can include ______ from improved outcomes

A

Savings

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30
Q

What may dictate primary source of income?

A

Service location

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31
Q

It is important to monitor, track, and forecast your income as well as?

A

Outcomes and interventions

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32
Q

What is the purpose of the service? 3

A
  1. Revenue generation
  2. Community outreach/ service
  3. Collaboration/ trust-building
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33
Q

What is vital to continually monitor, improve, and adapt your service?

A

Sustainability

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34
Q

What should you do for your service?

A

Advocate or market it

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35
Q

You should have a plan for costs ______ overtime and you should have a plan for covering the costs

A

Increasing

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36
Q

The description and analysis of the costs of drug therapy to health care systems and society

A

Pharmacoeconomics

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37
Q

Costs directly related to the provision of medical care

A

Direct medical

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38
Q

What do direct medical costs include? 4

A
  1. Medications
  2. Visits
  3. Hospitalizations
  4. Salary of medical personnel
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39
Q

Costs to patients and their families that are directly associated with treatment but are not medical in nature.

A

Direct non-medical

40
Q

What do direct non-medical costs include? 3

A
  1. Food
  2. Travel
  3. Lodging
41
Q

Costs that result from the loss of productivity due to illness or death

A

Indirect

42
Q

Costs that are difficult to put a monetary value on.

A

Intangible

43
Q

What do intangible costs include? 4

A
  1. Anxiety
  2. Pain
  3. Suffering
  4. Fatigue
44
Q

Converting future costs to present value

A

Discounting

45
Q

The process of estimating how future costs translate to present value

A

Discounting

46
Q

People often prefer benefits when?

A

Now rather than in the future

47
Q

What are the average rates of discounting in Pharmacoeconomic analyses?

A

3-5%

48
Q

When is discounting not used?

A

When timeframes are less than one year

49
Q

Converting historical costs to present value

A

Standardization

50
Q

The time frame over which costs and consequences are assessed in a Pharmacoeconomic analysis

A

Time horizon

51
Q

What kind of horizon is generally preferred but not always appropriate?

A

Lifetime

52
Q

What type of perspective is often preferred?

A

Societal

53
Q

In a PE, what is important to specify?

A

Perspective

54
Q

What are the 4 different types of perspectives?

A
  1. Patient
  2. Health system/ organization
  3. Insurance/government
  4. Society
55
Q

What types of costs are involved in the patient perspective?

A
  1. Direct medical
  2. Direct non-medical
  3. Intangible
  4. Indirect
56
Q

What types of cost are involved in the health payer perspective?

A
  1. Direct medical
  2. Indirect
57
Q

What types of costs are involved in the insurance perspective?

A
  1. Direct medical
58
Q

What types of costs are involved in the societal perspective?

A
  1. Direct medical
  2. Direct non medical
  3. Intangible
  4. Indirect
59
Q

Costs that are individually accounted for per unit of use

A

Micro-costing

60
Q

Costs that are estimated for groups of patients based on diagnosis and/or procedures and may include factors such as age and length of stay

A

Case-mix group

61
Q

The average daily costs for a specific disease

A

Disease specific per diem

62
Q

Average daily cost for all patients in a health system

A

Average per diem

63
Q

Pharmacoeconomic Evaluations: the outcome is not assessed

A

Cost analysis

64
Q

Pharmacoeconomic Evaluations: the outcome is not assessed, but assumed equivalent

A

Cost minimization

65
Q

Pharmacoeconomic Evaluations: outcomes are compared between alternatives

A
  1. Cost effectiveness
  2. Cost benefit
  3. Cost utility
66
Q

What is the most common type of Pharmacoeconomic Evaluations?

A

Cost effectiveness

67
Q

If the new alternative has lower effectiveness and the same cost as the standard, what is the outcome?

A

Newer is dominated by the current standard

68
Q

If the new alternative has the same effectiveness, but has a lower cost than the current standard, what is the outcome?

A

Newer alternative is dominant over the current standard

69
Q

If the new alternative has a higher effectiveness than the current standard, but has a lower cost, what is the outcome?

A

New alternative dominant over the current standard

70
Q

If the new alternative has the same effectiveness as the current standard, but has the same cost, what is the outcome?

A

Need to consider other costs/consequences

71
Q

If the new alternative has lower effectiveness than the current standard, but has a lower cost what is the outcome?

A

Need to calculate ICER

72
Q

If the new alternative has lower effectiveness than the current standard, but has a higher cost, what is the outcome?

A

Newer dominated by the current standard

73
Q

If the new alternative has the same effectiveness as the current standard, but has a higher cost, what is the outcome?

A

Newer alternative dominated by the current standard

74
Q

If the new alternative has a higher effectiveness than the current standard, but has the same cost, what is the outcome?

A

Newer alternative is dominant over the current standard

75
Q

If the newer alternative has a higher effectiveness than the current standard, but has a higher cost, what is the outcome?

A

Need to calculate the ICER

76
Q

True or false: you cannot compare across outcomes with cost effectiveness

A

True

77
Q

An approach to considering alternatives that incorporates the probability of an event with the cost of the events

A

Decision analysis

78
Q

What approach can facilitate translating indirect benefits to monetary units by calculating a persons daily wage by days of work missed

A

Human capital approach

79
Q

What approach facilitates the translation of indirect and intangible benefits to monetary units. Estimates how much people are willing to pay to reduce the chance of an adverse health outcome?

A

Willingness to pay approach

80
Q

What does the human capital approach undervalue?

A

Benefit for the unemployed

81
Q

What does the human capital approach not address?

A

Intangible benefits

82
Q

A measure of the relative preference for one option over another

A

Utility

83
Q

What is the range for utility?

A

0-1

84
Q

What is utility used to generate?

A

Quality adjusted life years

85
Q

Direct methods to generate utilities includes what 3 things?

A
  1. Rating scales
  2. Standard gamble
  3. Time trade off (living w disease for a certain pd of time or living w perfect health for a shorter amount of time)
86
Q

What do indirect methods used to generate utility consist of?

A

Mapping to preference based classification systems

87
Q

When individuals tend to overestimate their reaction to negative events

A

Projection bias

88
Q

Life years gained weighted by preferences

A

QALYS

89
Q

What is the cost effectiveness threshold traditionally?

A

$50,000/QALY

90
Q

If a ICER is below the stated threshold then it is considered what?

A

Cost effective

91
Q

What outcome format is associated with cost per outcome?

A

Cost effectiveness

92
Q

What outcome format is associated with benefit to cost ratio ?

A

Cost benefit

93
Q

What outcome format is associated with cost per quality of life year gained?

A

Cost utility

94
Q

True or false: you can compare different outcomes with cost benefit

A

True

95
Q

Analysis conducted to determine how the results will change if assumptions are varied over a range of values

A

Sensitivity analysis

96
Q

Type of analysis where you identify the point where the decision would change

A

Threshold analysis

97
Q

A way to visualize the results of a sensitivity analysis by arranging the various factors from the highest variability in incremental costs across the range of values you chose for the sensitivity analysis to those with the lowest variability in incremental costs

A

Tornado diagram

Didactic Exam 1 (3 decks)

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