Health Economics Flashcards
(31 cards)
What are opportunity costs?
The value of potential benefits which could be obtained from a resource when choosing one alternative over another
What is efficiency and what are 3 types of efficiency in relation to health care?
Efficiency refers to obtaining the greatest output for a given set of resources. The ability to avoid wasting materials, energy, efforts, money and time.
Technical
Productive
Allocative
What is technical efficiency
The effectiveness with which resources can be used to achieve a desired health outcome.
An intervention is technically inefficient if the same or greater outcome is achieved with less resources.
What is productive efficiency?
Compares alternative interventions based on the relative costs of the different resources.
To minimise the cost or to maximise the outcome
What is allocative efficiency?
Measuring the extent to which available resources are allocated to individuals who will benefit the most.
e.g. a treatment may be more beneficial to a high-risk group of patients
What is an economic evaluation of a health intervention?
Comparing 2 or more alternative interventions and considering both the costs and benefits of all alternative interventions being compared
What is a technology appraisal and what does it involve?
The process of which NICE evaluate existing and new treatments
- Review clinical and economic evidence
- Considering the health impact - talk to patients, manufacturers, clinicians
- Consider the cost effectiveness
- Comparing QALYs - quality of adjusted life years
- Normally of less than £20,000 per QALY = cost effective
- Social value judgements
- Pricing deals - patient access schemes
- Looking at clinical trial data to produce mathematical models to predict likely costs
How long do the NHS have to make a NICE recommended treatment available?
Within 3 months of its date of publication (unless otherwise specified)
What is the cost-effectiveness threshold for NICE per QALY?
£20-30K
What is the role of NICE?
To improve outcomes for people using the NHS and other public health and social care services.
By producing evidence-based guidance and advice for health, public health and social care practitioners.
Operate and evaluate therapies through QALYs
What is the Advisory Committee on Resource Allocation?
Replaced ‘Resource Allocation Working Party’.
Geographical allocation of money based on CCGs
What are the stages of cost analysis?
Identification - what resources might be affected by the programme or treatment
Measurement - how will we monitor the levels of resource used
Valuation - what is the value of the resources used
What are the 4 types of economic evaluation?
- Cost-utility analysis - different interventions for different outcomes - (e.g. QALYs)
- Cost-benefit analysis - benefits valued in monetary terms, willingness to pay, non-health benefits
- Cost-effectiveness analysis - different interventions for same health outcome (e.g. life years saved)
- Cost-minimisation analysis - same health outcome with different costs
What is the most favourable section on the cost-effectiveness plane?
Dominant - intervention is more effective and less costly
What is incremental cost effectiveness ratio?
A summary measure representing the economic value of an intervention, compared with an alternative.
(ICER) = (change in costs)/(change in effects)
Expressed as QALY
What is a QALY?
Quality Adjusted Life Year - a measure of the value of health outcomes.
Including the length of life and the quality of life
What is an Average Cost-Effective Ratio (ACER)?
The ratio of the cost to benefit of an intervention without reference to a comparator
ACER= COST/EFFECTIVENESS
What is the concept of equity in health care?
It is about fairness and justice.
Everyone should have an equal opportunity to attain their full potential for health.
Takes into account the need of the individual
What is the concept of equality in healthcare?
The equal distribution so that each individual receives the same amount.
-Equality may not be right as some individuals have different needs dependant on residency, ethnic group, sex, age, education, socioeconomic status, disability
What is the Beveridge Model?
NHS - Healthcare care system provided through the government for the public through general taxation and national insurance
What is the healthcare in the UK?
Universal, Government-funded health system
NHS - funded from general taxation
Free at point of use
Based on principle of equal access for equal need
Provides universal coverage although some exemptions such as med charges
GPs act as gate keepers and services now commissioned by CCGs
Lowest % of their GDP on health care than other European countries
What is the US Health Service
Non-universal insurance system
Largely private insurance mainly funded through employment
Large public sector - medicaid, medicare
Does not provide universal coverage
Extremely expensive system
Obama care - attempt to make insurance compulsory
What are disadvantages of the NHS compared to other countries?
Waiting times
Lower numbers of doctors and nurses per head
Hospital beds per head
Lower survival rates for breast and cervical cancer
Higher health-care amendable mortality
Higher infant mortality
What are advantages of the NHS?
Universal coverage - available to all citizens
Equitable
Free at the point of access
Control costs in line with affordability
