Session 8 - Part II Flashcards Preview

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Flashcards in Session 8 - Part II Deck (21)
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0
Q

What is opportunity cost?

A

Value of the next best alternative use of those resources
Measured in benefits foregone
Eg nurse costs £20,000, opportunity cost = lost benefit to 50 children needing overnight stay in hospital.

1
Q

What are the basic concepts in health economics?

A

Scarcity - need outstrips resources so prioritisation needed
Efficiency - getting the most of out limited resources
Equity - extent to which distribution is fair
Effectiveness - extent to which intervention produces desired outcomes
Utility - vale an individual places on a health state
Opportunity cost - once you have used a resource in one way, you no longer have it to use in another way

2
Q

What are the 2 methods for looking at efficiency?

A

Technical - how to meet needs, most efficient way of delivering care
Allocative - choosing which needs should be met

3
Q

What is economic evaluation?

A
Comparison of resource implications and benefits of alternative ways of delivering healthcare
Underpinned by the concepts of;
Scarcity/sacrifice
Efficiency
Opportunity cost
Utility
4
Q

How do you measure costs?

A

Hard to measure

Identify, quantify and value resources needed

5
Q

What are the categories of costs?

A
Costs of health care services
Costs of the patients time
Costs associated with care giving
Other costs associated with illness
Economic costs
6
Q

How do you measure benefits?

A

Hard to measure
QALY
QoL

7
Q

What are the categories for benefits?

A

Impact on health status
Savings in other health care resources
Improved productivity (if patient returns to work earlier)

8
Q

What are the 4 types of economic evaluation for comparing costs and benefits?

A

Cost minimisation analysis
Cost effectiveness analysis
Cost benefit analysis
Cost utility analysis

9
Q

What is cost minimisation analysis?

A

If all of the treatments/interventions have the same effectiveness, use the cheapest one

10
Q

What is cost effectiveness analysis?

A

If one intervention/treatment is more effective, but also more expensive, is the increased effectiveness worth the extra money

11
Q

What is cost benefit analysis?

A

All inputs/outputs are assigned a cost and valued
Best for interventions outside of healthcare
Methodical issues due to putting a price on people’s lives

12
Q

What is a QALY?

A

Quality Adjusted Life Year
One year of healthy life for one person
1 QALY = 2 years at 50% QoL for 1 person

13
Q

What is sensitivity analysis?

A

Check effects of assumptions

14
Q

What is discounting?

A

Method of calculating present values and outcomes which accrue in the future

15
Q

Why would you use QALYs?

A

Use cost effectiveness as a guide to decision making
Allows broad comparisons across differing programmes
Life years gained = only where survival is main outcome
QALY = composite of survival and quality of life

16
Q

How do QALYs help NICE choose treatments?

A

Assess cost effectiveness, it is integrated with the price of the treatment using the incremental cost effectiveness ratio (which represents the change in costs in relation to the change in health status)

17
Q

What does NICE appraise when choosing treatments?

A

Clinical effectiveness

Cost effectiveness

18
Q

What are the decisions on treatments NICE would make for cost?

A

Below £20K per QALY = normally approved
£20 - £30K per QALY = judgements needed
30K per QALY = a very strong case needed

19
Q

What are the criticisms of QALYs?

A

Do not distribute resources according to need, but according to the benefits gained per unit of cost
Calculation issues - usually use RCTs, May not be enough evidence and different to putting into real world
May not embrace all dimensions of benefit, values expressed by participants my not represent whole population
Controversy about values they embody

20
Q

What are the issues with NICE?

A

Resented by patient groups, especially those with long term conditions
Resented by pharmaceutical companies
PCTs are forced to follow their guidelines
Political interference