Flashcards in 12) Resource Allocation Deck (23):
Why do we need priorities when discussing resources?
Scarcity of resources
Rationing of resources and services
Why is NHS spending having to increase?
Elderly population rising (LTC)
Increased incidence of cancer with expensive therapies required
New therapies can be used on more people
What is explicit rationing?
Decisions and reasons based on defined rules of entitlement (who gets what)
What is implicit rationing?
Care limited, but neither decisions, nor basis for those decisions, are clearly expressed
What are the disadvantages of implicit rationing?
Leads to inequality and discrimination
Open to abuse
Decisions based on perceptions of social deservingness
What are the advantages of explicit rationing?
Opportunity for debate
What are the disadvantages of explicit rationing?
Patient and professional hostility
Impact on clinical freedom
Lack of heterogeneity of patient and illness
What are the functions of NICE in terms of resources (treatments)?
Guidance on treatments recommended for use in NHS
Appraise new drugs to make sure effective and cost effective products are available
What are the concepts of health economics?
What is opportunity cost?
The loss of other alternatives when one alternative is chosen
What is technical efficiency?
Most efficient way of meeting a need e.g. should a service be community or hospital based
What is allocative efficiency?
Choosing between the many needs to be met (one treatment vs another)
How can costs of resources be measured?
Cost of healthcare services
Cost of patient time
Costs associated with care giving
How can benefits of resources be measured?
Impact on health status (QoL and survival)
Saving in other healthcare resources
Improved productivity (return to work earlier)
What is cost minimisation analysis?
Outcomes considered equivalent so focus is on cost (input)
What is cost effectiveness analysis?
Compare interventions with common health outcomes
What is cost benefit analysis?
Inputs and outputs in monetary terms, allows comparison with interventions outside of healthcare
What is cost utility analysis?
Focuses on quality of health outcomes produced or foregone. Uses quality adjusted life year (QALY) for comparison
Why do we use QALYs?
Assess cost effectiveness and used in decision making
How can quality of life be measured?
What are some alternatives to QALYs?
Health Year Equivalents
Saved Young Life Equivalents
Disability Adjusted Life Years
How do NICE use QALYs?
Cost per QALY used to determine cost-effectiveness of treatment