Health Econ Midterm
Terms in this set (68)
A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
The maintenance and improvement of health especially through the provision of medical services
The extent to which health services provided to individuals and patient populations improve desired outcomes
The scientific study of the choices made by individuals and societies in regard to the alternative uses of scarce resources which are employed to satisfy wants
a branch of economics concerned with issues related to scarcity in the allocation of health care
Description and analysis of the costs and consequences of pharmaceuticals and pharmaceutical services, and its impact on individuals, health care systems, and the society
Studies that identify, measure and evaluate the end results (outcomes) of health care services and which also accounts patient's perspective
The [monetary] value of all goods, services, and other resources that are consumed in the provision of an intervention or related consequences
Intermediate and final endpoints
Expenditures of money in return for goods and services
expenses with added markup in order to generate revenue, Acquisition cost + Operating cost + Mark up, selling price
Costs that are associated with prevention, detection or disease/illness treatment or health care delivery
Costs/resources directly related to care
Costs to patient and families related to care, but of non-medical nature.
Costs that impacts patient(s) or the society, costs resulting from morbidity and mortality
Costs related to time lost and productivity due to an illness or lost wages
Cost related to life lost due to an illness
Most obscure and difficult to measure, associated with the psychological impact of a disease/treatment on health, such as on quality-of-life or treatment satisfaction.
Costs required to purchase an
additional outcome/unit of service/benefit, can be used to measure the economic impact of one program over the other
Cost of producing one extra unit of an
outcome/service/unit/benefit, used interchangeably with incremental cost
Value of an opportunity that was given up (forgone), resources committed to one program/service are no longer available for anything else.
Consumer Price Index (CPI)
A measure of the average change over time in the prices paid by urban consumers for a market basket of consumer goods and service
Net Present Value (NPV)
PE tool for comparing all of the relevant costs and consequences of two or more therapeutic interventions. Objective is to choose least costly alternative among equivalent or clinically efficacious, alternatives. Comparison of alternatives is purely by cost. Assumes medical interventions are both clinically efficacious, effective, and equivalent.
Which analysis favors payer?
Always a direct cost, Sometimes an indirect cost, rarely an intangible cost
Assesses whether the outcomes (benefits) of a program outweigh the inputs (costs), used to help make decisions about public policy, balance of individual preferences and social welfare, effective and efficient use of resources.
Benefit/cost, intervention time ≤1 year
Internal rate of return
rate of return that
equates the PV of benefits to the PV of costs
The least used PE method, prevention, screening, diagnostics, pharmaceuticals, education
Used when natural heath units/outcomes are NOT equal in efficacy or effectiveness, and NOT DESIRABLE to value them in monetary terms; the most common type of PE analysis in the literature.
Average cost of obtaining a specific therapeutic outcome, cost per unit of benefit of a strategy independent of other alternatives
Cost /Outcome in natural unit
Additional cost and additional benefit when one option is compared to the next most expensive or intensive option, cost per unit benefit of switching from one strategy to another
Diff in cost/diff in outcome, Incremental cost/incremental benefit
[WTP x Incremental benefit] - Incremental cost
an extension of CEA that integrates both costs and consequences of intervention within the utility framework, measures the costs of therapy in relation to a patient's perceived quality-of-life or other measure of patient preference, uses final outcomes unlike CEA, where intermediate
outcomes can be used, can incorporate multiple outcomes unlikeCEA
quality adjusted life year
health year equivalents
quality adjusted life expectancy
disability adjusted life years
When QOL is an important outcome (chemo increases survival but also impacts QOL, arthritis impacts social and functional health etc.), When both morbidity and mortality are important outcomes (post menopausal estrogen therapy improves QOL but also increases mortality), When there are a wide range of outcomes to be compared across programs (NICU vs. HTN clinic)
Do NOT use CUA
When only intermediate outcomes are available. When alternatives are equally effective.
When natural units can do a good job.
When extra cost of obtaining and using utility values, itself is not cost effective.
Y x Q
Also referred to as burden of illness/disease on the society, Identifies and estimates the overall costs [mostly direct and indirect, sometimes intangible cost] for a particular disease in a defined population, helps in appropriate allocation of resources for disease in question and helps define budgetary goals
More common, as it is inclusive of new and existing cases and easier to use than incidence approach, estimates the costs of a disease in a specific period of time for all people regardless of time of their diagnosis, most appropriate for diseases whose effects can be measured in time period of the analysis
More difficult and used less frequently due to following reasons: Lack of info on disease progression and survival probabilities; difficulty with current and future projections of incidence rates and treatment patterns, Most appropriate for cost comparisons involving chronic diseases (HTN, DM, etc.), Provides more accurate baseline for estimating benefits of a new treatment over many years and measuring life time costs of a disease
researchers follow patients over time to collect data
researchers go back to collect the resources used and adjust these to the base year price
Direct medical costs
Medications, medication monitoring, medication administration, patient counseling and consultations, diagnostic tests, hospitalizations, clinic visits, emergency department visits, home medical visits, ambulance services, nursing services.
Top down (population based)
also known as epidemiological or attributable risk approach, measures the proportion of a disease that is due to exposure or risk factors.
Bottom up (person based)
often multiplies the unit cost of a particular treatment by the average amount of treatment utilization to get an average cost estimate.
uses one large or national data set and regression method for calculating incremental cost; useful for calculating cost attributable to risk factors or secondary diagnoses
Direct non-medical costs
Travel costs (bus, gas, taxi), non medical assistance related to condition (meals-on-wheels, homemaking services), Hotel stays for patient or family for out of town care, child care services for children of patients
Examples of indirect costs
Lost productivity for patient, lost productivity for unpaid caregiver (family member, neighbor, friend), lost productivity because of premature mortality
Human capital approach
Most often used, measures individual's productive contribution to the society through individual's earnings
Friction cost method
Measures only the production losses during the time it takes to replace a worker. It assumes short term losses can be made up by replacement worker during friction period.
Applying different values for factors where uncertainty exists to determine the possible range of costs
Total cost burden equation
Per patient cost (Direct costs + Indirect costs + Intangible costs) x either prevalence OR incidence of a disease/condition in population
Most commonly used, secondary data,
published studies, claims databases
Most commonly used, secondary data,
published studies, claims databases
Frequently used sources
hospital records (demographics, diagnosis codes, procedure codes, MD information, severity of illness rating)