Lecture bioinformatic databases - Wednesday - Economic evaluations
17 important questions on Lecture bioinformatic databases - Wednesday - Economic evaluations
How to reduce healthcare costs?
Not all care in all hospitals
Higher healthcare insurance premiums
Control wages and prices
More care in the supplementary insurance
Less care in the basic insurance package
The last two are the best solutions to reduce healthcare costs for the public
Why do we have health economics?
- Mandatory health insurance, should be worth the cost
- Willingness to pay more
What are the costs from a medical view?
- complementary care or substitution (direct costs)
- costs in gained life years (indirect costs)
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What are the costs of societal perspective?
- Costs for patients and family (travel and time costs)
- Costs in other sectors (education, consumption)
--> disability, absents, less efficient at work (presenteeism) etc.
--> also other points of view could be used: doctor, insurer, patient etc.
How are costs determined in the Netherlands?
In England, they look from the medical perspective.
Types of economic evaluations
- Costs associated with a diagnosis
- No comparison of policies
- Which policy is less expensive
- Without looking at effectiveness
- Costs and other societal influences
- Evaluation of government policy
There are four categories for cost-effectiveness analysis, which four?
Better - less expensive is always implemented
The other two depends on the effectiveness ratio: extra costs/extra effectiveness
How is the cost-effectiveness ratio calculated?
When can the Cost-effectiveness analysis (CEA) be applied?
What analysis can be used to compare between diseases?
What is disease burden?
-> measures are healthy life years and quality-adjusted life years
What is the difference between healthy life years and quality adjusted life years?
QALYs = life expectancy adjusted for quality of life, weighs by utility (=value of QoL). Possibly with discounting = weighing the future less than the present
Is discounting (giving less weight to the future) favorable or unfavorable for prevention?
What is the area under the utility curve?
What is an advantage and disadvantage about QALYs?
- Only measures health outcome (ignores process, ethics, relations, prognosis, purpose in life etc)
- A meager measure for 'the good life'
- Higher age gives less benefit from improving QoL
- Poor health gives less benefit from living longer
- Broadly applicable and comparable
- Patient's health is what counts
- Suitable as an economic assessment framework
How is ICUR calculated? = incremental cost utility ratio
If you want to compare two scenario's, the cost-effectiveness ratio is often used. How do you calculate this ratio?
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