Podcast
Questions and Answers
Which of the following is not a commonly recognized means of economic evaluation in the case of health care?
Which of the following is not a commonly recognized means of economic evaluation in the case of health care?
- Cost-Equity Analysis (correct)
- Cost-Utility Analysis
- Cost-Effectiveness Analysis
- All of the above are commonly practiced
QALYs are a means of quantifying the benefits of a medical intervention that takes both the quantity and quality of life lived into account. QALYs are used in which type of economic evaluation?
QALYs are a means of quantifying the benefits of a medical intervention that takes both the quantity and quality of life lived into account. QALYs are used in which type of economic evaluation?
- Cost-Benefit Analysis
- Cost-Effectiveness Analysis
- Cost-Minimization Analysis
- None of the above (correct)
If an evaluator wanted to place a heavy weight on the considerations of future generations, they would?
If an evaluator wanted to place a heavy weight on the considerations of future generations, they would?
- Use a high discount rate
- Use a moderate discount rate
- Use a low discount rate (correct)
- Use a discount rate equal to the inflation rate
Cost-effectiveness analysis is poorly suited for programs with multiple types of health outcomes.
Cost-effectiveness analysis is poorly suited for programs with multiple types of health outcomes.
A recent study by Health Canada, the federal Department of Health, that calculated the economic burden imposed by leading diseases in Canada (e.g., health care costs, lost work productivity, etc.) constitutes an economic evaluation.
A recent study by Health Canada, the federal Department of Health, that calculated the economic burden imposed by leading diseases in Canada (e.g., health care costs, lost work productivity, etc.) constitutes an economic evaluation.
Economists generally recommend that economic evaluations be conducted from the viewpoint of all members of society.
Economists generally recommend that economic evaluations be conducted from the viewpoint of all members of society.
Because it incorporates a subjective utility weight into the calculation of quality-adjusted life-years, cost-utility analysis can address questions of allocative efficiency.
Because it incorporates a subjective utility weight into the calculation of quality-adjusted life-years, cost-utility analysis can address questions of allocative efficiency.
Other things equal, the higher is the rate of time preference, the more attractive will investments in prevention programs be from an economic point of view.
Other things equal, the higher is the rate of time preference, the more attractive will investments in prevention programs be from an economic point of view.
The use of the net-benefit measure to summarize the results of a cost-benefit study follows directly from the Pareto efficiency principle.
The use of the net-benefit measure to summarize the results of a cost-benefit study follows directly from the Pareto efficiency principle.
Health economists believe that the relevant aspect of health is
Health economists believe that the relevant aspect of health is
Focusing on your total product of health due to health care, moving to a new area
with less industrial pollution will likely
Focusing on your total product of health due to health care, moving to a new area with less industrial pollution will likely
McKeown showed that majority of historically rapidly falling rates of mortality
for common diseases occurred
McKeown showed that majority of historically rapidly falling rates of mortality for common diseases occurred
More education is correlated with better health because people with “long time
horizons” with preferences for the future tend to invest in both. Therefore we
should increase subsidies to education in order to increase health.
More education is correlated with better health because people with “long time horizons” with preferences for the future tend to invest in both. Therefore we should increase subsidies to education in order to increase health.
The concept of the social gradient in health means that there exists a social cost
curve which lies above the private marginal cost curve (commonly known as the
supply curve) which shows the full true cost of supply.
The concept of the social gradient in health means that there exists a social cost curve which lies above the private marginal cost curve (commonly known as the supply curve) which shows the full true cost of supply.
Give an example of how health might be produced from a market good. Give an
example of how health might be produced from a non-market good.
Give an example of how health might be produced from a market good. Give an example of how health might be produced from a non-market good.
Uncertainty regarding the effectiveness of a specific health service for a particular
individual:
Uncertainty regarding the effectiveness of a specific health service for a particular individual:
Informational asymmetry in the market for health care services refers to:
Informational asymmetry in the market for health care services refers to:
Which of the following characteristics of health care plays an important role in
defining need:
Which of the following characteristics of health care plays an important role in defining need:
Because health care consumers often do not know what would have happened to their
condition even if they had not consumed a particular health care service:
Because health care consumers often do not know what would have happened to their condition even if they had not consumed a particular health care service:
The increasing number of antibiotic resistant bacteria caused by over-consumption of
antibiotics is an example of:
The increasing number of antibiotic resistant bacteria caused by over-consumption of antibiotics is an example of:
Which of the following is a reason why some health economists argue that we should
not interpret the area under the demand curve for health care as representing the value
of health care to an individual?
Which of the following is a reason why some health economists argue that we should not interpret the area under the demand curve for health care as representing the value of health care to an individual?
The demand for hospital care is generally:
The demand for hospital care is generally:
The Rand Health Insurance Experiment found that the consumption of physician visits
did respond negatively to cost-sharing while the expected total cost of visits did not.
This would be consistent with the phenomenon of:
The Rand Health Insurance Experiment found that the consumption of physician visits did respond negatively to cost-sharing while the expected total cost of visits did not. This would be consistent with the phenomenon of:
The problem of informational asymmetry in health care markets can undermine the
normative interpretation of the demand curve as representing marginal benefit.
The problem of informational asymmetry in health care markets can undermine the normative interpretation of the demand curve as representing marginal benefit.
If a doctor is a perfect agent for her patients, she will always provide care that is
expected to improve a patient's health.
If a doctor is a perfect agent for her patients, she will always provide care that is expected to improve a patient's health.
The physician's ability to influence a person's consumption of health care services
arises from externalities.
The physician's ability to influence a person's consumption of health care services arises from externalities.
The concept of need in health care derives from the presence of externalities in health
care markets.
The concept of need in health care derives from the presence of externalities in health care markets.
If we define a health care service as needed if the expected health effect for a person
is positive, then society should ensure that all health care needs are met.
If we define a health care service as needed if the expected health effect for a person is positive, then society should ensure that all health care needs are met.
The demand curve for health care provides a good measure of the benefits of health care to a consumer.
The demand curve for health care provides a good measure of the benefits of health care to a consumer.
There is a large health care literature that examines variation across regions in the
per-capita utilization of health care services. Such studies consistently find that rates
of variation of many procedures can vary 2-5 fold even after adjusting for differences
in the age-sex distributions of the population. Many studies also find that utilization
per capita is positively correlated with physician supply. The most logical explanation
of these findings is self-interested supplier-induced demand.
There is a large health care literature that examines variation across regions in the per-capita utilization of health care services. Such studies consistently find that rates of variation of many procedures can vary 2-5 fold even after adjusting for differences in the age-sex distributions of the population. Many studies also find that utilization per capita is positively correlated with physician supply. The most logical explanation of these findings is self-interested supplier-induced demand.
Even when care is free at the point of service, we would expect low and high-income
individuals with the same level of need to demand different quantities of health
care.
Even when care is free at the point of service, we would expect low and high-income individuals with the same level of need to demand different quantities of health care.
For two individuals who have identical probabilities of being ill and identical monetary
losses associated with being ill, but who have differing risk preferences:
For two individuals who have identical probabilities of being ill and identical monetary losses associated with being ill, but who have differing risk preferences:
A new drug has been developed that is effective in preventing heart attacks. Before the
new drug was developed, an average 55-year-old man had a 20% chance of a heart
attack and the loss associated with the attack was $4000. Taking the drug reduces the
chance of a heart attack to 10%, but the loss associated with the attack increases to
$8000. All else equal, if a 55-year-old man begins taking the new drug, the maximum
premium he would be willing to pay for health insurance to cover the loss associated
with a heart attack:
A new drug has been developed that is effective in preventing heart attacks. Before the new drug was developed, an average 55-year-old man had a 20% chance of a heart attack and the loss associated with the attack was $4000. Taking the drug reduces the chance of a heart attack to 10%, but the loss associated with the attack increases to $8000. All else equal, if a 55-year-old man begins taking the new drug, the maximum premium he would be willing to pay for health insurance to cover the loss associated with a heart attack:
The effectiveness of pooling financial risk through insurance:
The effectiveness of pooling financial risk through insurance:
A risk-averse individual prefers all situations with certainty compared to a risky
prospect.
A risk-averse individual prefers all situations with certainty compared to a risky prospect.
If an insurance company charges more than the actuarially fair premium, people will
not buy insurance.
If an insurance company charges more than the actuarially fair premium, people will not buy insurance.
Risk aversion is a necessary condition for insurance to be welfare improving to an
individual.
Risk aversion is a necessary condition for insurance to be welfare improving to an individual.
Flashcards
Cost-Equity Analysis
Cost-Equity Analysis
Not a commonly recognized means of economic evaluation in healthcare.
QALYs
QALYs
QALYs quantify medical intervention benefits considering both the length and quality of life.
Emphasis on future generations
Emphasis on future generations
Use a low discount rate. This gives future benefits a higher present value.
Cost-effectiveness analysis
Cost-effectiveness analysis
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Economic evaluation
Economic evaluation
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Societal viewpoint in economics
Societal viewpoint in economics
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Cost-utility analysis
Cost-utility analysis
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Time preference rate
Time preference rate
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Net-benefit measure
Net-benefit measure
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Study Notes
- The topic is economic evaluation in healthcare.
Economic Evaluation Methods
- Cost-Equity Analysis is not a commonly recognized means of economic evaluation in healthcare.
- Cost-Utility Analysis and Cost-Effectiveness Analysis are commonly practiced methods.
QALYs in Economic Evaluation
- QALYs quantify the benefits of medical interventions by considering both the quantity and quality of life.
- QALYs are used in Cost-Benefit Analysis.
Discount Rate Considerations
- Evaluators placing heavy weight on future generations should use a low discount rate.
- High discount rates would de-emphasize future costs and benefits.
Cost-Effectiveness Analysis
- Cost-effectiveness analysis measures outcomes in natural units.
- It is poorly suited for programs with multiple types of health outcomes as each outcome is measured in a different unit and cannot be combined into a single indicator.
- Cost-effectiveness analysis is better suited to situations with a single, primary outcome of a treatment that is of interest.
Economic Evaluation Requirements
- An economic evaluation must compare two or more programs in terms of their costs and benefits.
- A study that calculates the economic costs to society without comparing programs or interventions doesn't qualify as an economic evaluation.
- Furthermore, the study considers only one aspect (the costs of disease) rather than the costs and consequences of a course of action.
Societal Perspective in Economic Evaluations
- Economists recommend conducting economic evaluations from the viewpoint of all members of society to maximize social welfare.
- Failing to do so gives zero weight to the costs borne or benefits obtained by some members of society.
- Viewpoint refers to the set of people and organizations whose costs and benefits are included in the evaluation.
Cost-Utility Analysis and Allocative Efficiency
- Cost-utility analysis incorporates subjective values into the calculation of quality-adjusted life-years (QALY).
- Cost-utility analysis only answers the question of the least expensive way to produce a QALY.
- It cannot, through the analysis itself, reveal whether a program would generate positive net benefit to society and address questions of allocative efficiency.
- Policy makers must judge whether producing QALYs at the indicated cost is a good investment.
- In contrast, cost-benefit analysis produces a measure of the net benefit to society under all the assumptions associated with CBA.
Time Preference and Prevention Programs
- A higher rate of time preference means that a person weights costs and benefits that occur now or in the near future much more heavily than costs and benefits that arise far in the future.
- Prevention programs are generally characterized by high up-front costs followed by benefits in the future.
- Preventive programs are less attractive to those with high rates of time preference than for those with low rates of time preference.
Net-Benefit Measure and Pareto Efficiency
- The use of the net-benefit measure to summarize the results of a cost-benefit study does not follow directly from the Pareto efficiency principle.
- The net-benefit principle deems an allocation efficient if it increases net benefit.
- Note that many individuals may be harmed by the action, but if the gains by those are sufficiently large, the action is deemed efficient.
- The net-benefit measure corresponds more closely with the potential Pareto criterion.
- In contrast, the Pareto efficiency principle deems an allocation efficient if it is impossible to reallocate resources so as to make at least one person better off while not making anyone else worse off.
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