WEEK 2: Clinical efficiency Flashcards
What is efficiency?
Efficiency measures whether healthcare resources
are being used to get the best value for money
What 2 aspects are efficiency mostly concerned about?
Efficiency is concerned with the relation between
resource inputs (costs, in the form of labour, capital,
or equipment) and either intermediate outputs
(numbers treated, waiting time, etc) or final health
outcomes (lives saved, life years gained, quality
adjusted life years (QALYs)).
Although many evaluations use intermediate outputs as a measure of effectiveness, this can lead to suboptimal recommendations.
Ideally economic evaluations should focus
on final health outcomes
State the importance of adopting economic efficiency.
Adopting the criterion of economic efficiency
implies that society makes choices which maximise the
health outcomes gained from the resources allocated
to healthcare.
Outline the 3 concepts of efficiency.
This note examines three concepts of
efficiency: technical, productive, and allocative.
Define technical efficiency.
When do we say an intervention is technically efficient?
Technical efficiency refers to the physical relation
between resources (capital and labor) and health
outcome.
A technically efficient position is achieved
when the maximum possible improvement in outcome
is obtained from a set of resource inputs
When do we say an intervention is technically inefficient?
Give an example.
An intervention is technically inefficient if the same (or
greater) outcome could be produced with less of one
type of input.
Consider treatment of osteoporosis using alendronate.
A recent randomized trial showed that a 10 mg daily dose was as effective as a 20 mg dose.4 The lower dose is technically more efficient.
Define productive efficiency.
Give example.
- The concept of productive efficiency refers to the maximisation of health outcome for a given cost, or the minimization of cost for a given outcome.
In health care, productive efficiency enables assessment of the relative value for money of interventions with directly comparable outcomes. It cannot address the impact of reallocating resources at a broader level—for example, from geriatric care to mental illness—because the health outcomes are incommensurate.
- If the sum of the costs of the new biochemical screening programme is smaller than or the same as the maternal age programme and outcomes are equal or better, then the biochemical programme is productively efficient in relation to the maternal age programme.
Define allocative efficiency.
Allocative efficiency—Is achieved when resources are allocated so as to maximize the welfare of the community.
To inform resource allocation decisions in this broader context a global measure of efficiency is required.
The concept of allocative efficiency takes account not only of the productive efficiency with which healthcare resources are used to produce health outcomes but also the efficiency with which these outcomes are distributed among the community.
Compare the 3 concepts of efficiency.
Technical efficiency addresses the issue of using given resources to maximum advantage.
Productive efficiency of choosing different combinations of
resources to achieve the maximum health benefit for a
given cost.
Allocative efficiency of achieving the right mixture of healthcare programmes to maximize the health of society.
Q: What happens to resource allocations under the concept of allocative efficiency in scenarios with limited resources?
A: In situations with constrained resources, the concept of allocative efficiency eliminates some resource allocations that are technically efficient. This means that certain resource allocations may be disregarded despite being technically efficient.
Q: How do limited resources impact the concept of productive efficiency?
A: Limited resources necessitate the exclusion of technically efficient resource input combinations deemed “inefficient” under the concept of productive efficiency. This means that some technically efficient resource input combinations may be labeled as inefficient due to constraints.
Q: What does productive efficiency involve, and how does it relate to technical efficiency and allocative efficiency?
A: Productive efficiency encompasses both technical efficiency and allocative efficiency. However, while productive efficiency implies technical efficiency and allocative efficiency, the reverse implications do not always hold true.
