Economic perspectives on health
,Examenvragen:
- Je mag rekenmachine gebruiken + handboek voor deel 2
- Les 1) wat is mozard hazard, supply induced demand, conclusive van de roze grafiek
- Les 3) je krijgt een oefening van QALY. Het antwoord moet je neerschrijven van je berekening,
- In het handboek mag je schrijven, maar niets van deel 1 in het boek (P4Q, P4P)
- 5 vragen deel 1
- 5 vragen deel 2 (oefeningen 1 of 2)
- Vraag over P4Q
- 1 vraag Ruben van de 4 diabets
- Open en gesloten vragen
- Als je een fout maakt in je berekening krijg je nog een punten voor de berekening
- Chapter guideliness moet je niet kennen → al de rest moet je kennen
- Paragraph 3.4 (prospective health economic evaluations) is not to be studies
- Chapter 4 (guidelines) is not to be studies, except for the paragraph on discounting (guideline 9).
,Inhoudsopgave
Deel 1. ...................................................................................................................................................... 5
1. Healthcare systems and policy ............................................................................................................. 5
1.1. The conflicting goals of healthcare policy ..................................................................................... 5
1.2. The current challenges of most healthcare systems ..................................................................... 7
1.3. Externalities: why care about the health of others? ................................................................... 13
1.4. We have to change our policies .................................................................................................. 17
2. The possible policy response ............................................................................................................. 17
2.1. What can policy makers do ......................................................................................................... 17
2.1.1. Selecting the right healthcare system ...................................................................................... 17
2.1.2. Integrated care ........................................................................................................................ 22
2.1.3. Strong primary care (sterke basiszorg) .................................................................................... 25
2.1.4. Change financial incentives...................................................................................................... 29
2.1.5. Invloed op out of pocket betalingen ........................................................................................ 35
2.5.6. Investeren in preventie ............................................................................................................ 36
3. The role of the EU .............................................................................................................................. 42
3.1. Fundamenten.............................................................................................................................. 42
3.2. Oefeningen ................................................................................................................................. 44
Deel 2. An introduction to health economic evaluations ....................................................................... 48
2.1. Why health economics and health technology assessment?...................................................... 48
2.2. Basics of cost-effectiveness analysis ........................................................................................... 49
2.3.1. health economic evaluation: a simple definition ................................................................. 49
2.3.2. Costs and savings ................................................................................................................. 53
2.3. Gezondheidseconomische modellen .......................................................................................... 61
2.3.1. Beslissingsboom, eenvoudige oefening ............................................................................... 61
2.3.2. Markov models .................................................................................................................... 65
2.3. Hoe maak je modellen geloofwaardig en betrouwbaar? ............................................................ 73
2.3.1. Gevoeligheidsanalyse........................................................................................................... 74
2.3.2. Tornado diagram.................................................................................................................. 74
2.3.1. Probabilistische sens. Analyse (= Monte Carlo analyse): voorbeeld ........................................ 76
2.3.2. Conclusie .................................................................................................................................. 77
2.4. Gezondheidseconomische evaluatie en decision making ............................................................... 77
2.4.1. Uitdaging: de huidige QALY-benadering is onvoldoende patiëntgericht ................................. 78
2.4.2. Budget impact .......................................................................................................................... 81
2.4.3. onzekerheid ............................................................................................................................. 82
2.3.5. HTA moet overal in de innovatiecyclus aanwezig zijn .............................................................. 84
, Deel 3. The economics behind prevention and health promotion ........................................................ 88
3.1. Redenen voor de stijging van kosten .......................................................................................... 89
3.2. wie is hier verantwoordelijk voor? .............................................................................................. 90
3.3. feel4diabetes ............................................................................................................................ 102
3.3.1. Doel van de studie ............................................................................................................. 103
3.3.2. de interventie..................................................................................................................... 104
4. Oefeningen ...................................................................................................................................... 113
4.1. Oefening 1 ................................................................................................................................ 113
,Examenvragen:
- Je mag rekenmachine gebruiken + handboek voor deel 2
- Les 1) wat is mozard hazard, supply induced demand, conclusive van de roze grafiek
- Les 3) je krijgt een oefening van QALY. Het antwoord moet je neerschrijven van je berekening,
- In het handboek mag je schrijven, maar niets van deel 1 in het boek (P4Q, P4P)
- 5 vragen deel 1
- 5 vragen deel 2 (oefeningen 1 of 2)
- Vraag over P4Q
- 1 vraag Ruben van de 4 diabets
- Open en gesloten vragen
- Als je een fout maakt in je berekening krijg je nog een punten voor de berekening
- Chapter guideliness moet je niet kennen → al de rest moet je kennen
- Paragraph 3.4 (prospective health economic evaluations) is not to be studies
- Chapter 4 (guidelines) is not to be studies, except for the paragraph on discounting (guideline 9).
,Inhoudsopgave
Deel 1. ...................................................................................................................................................... 5
1. Healthcare systems and policy ............................................................................................................. 5
1.1. The conflicting goals of healthcare policy ..................................................................................... 5
1.2. The current challenges of most healthcare systems ..................................................................... 7
1.3. Externalities: why care about the health of others? ................................................................... 13
1.4. We have to change our policies .................................................................................................. 17
2. The possible policy response ............................................................................................................. 17
2.1. What can policy makers do ......................................................................................................... 17
2.1.1. Selecting the right healthcare system ...................................................................................... 17
2.1.2. Integrated care ........................................................................................................................ 22
2.1.3. Strong primary care (sterke basiszorg) .................................................................................... 25
2.1.4. Change financial incentives...................................................................................................... 29
2.1.5. Invloed op out of pocket betalingen ........................................................................................ 35
2.5.6. Investeren in preventie ............................................................................................................ 36
3. The role of the EU .............................................................................................................................. 42
3.1. Fundamenten.............................................................................................................................. 42
3.2. Oefeningen ................................................................................................................................. 44
Deel 2. An introduction to health economic evaluations ....................................................................... 48
2.1. Why health economics and health technology assessment?...................................................... 48
2.2. Basics of cost-effectiveness analysis ........................................................................................... 49
2.3.1. health economic evaluation: a simple definition ................................................................. 49
2.3.2. Costs and savings ................................................................................................................. 53
2.3. Gezondheidseconomische modellen .......................................................................................... 61
2.3.1. Beslissingsboom, eenvoudige oefening ............................................................................... 61
2.3.2. Markov models .................................................................................................................... 65
2.3. Hoe maak je modellen geloofwaardig en betrouwbaar? ............................................................ 73
2.3.1. Gevoeligheidsanalyse........................................................................................................... 74
2.3.2. Tornado diagram.................................................................................................................. 74
2.3.1. Probabilistische sens. Analyse (= Monte Carlo analyse): voorbeeld ........................................ 76
2.3.2. Conclusie .................................................................................................................................. 77
2.4. Gezondheidseconomische evaluatie en decision making ............................................................... 77
2.4.1. Uitdaging: de huidige QALY-benadering is onvoldoende patiëntgericht ................................. 78
2.4.2. Budget impact .......................................................................................................................... 81
2.4.3. onzekerheid ............................................................................................................................. 82
2.3.5. HTA moet overal in de innovatiecyclus aanwezig zijn .............................................................. 84
, Deel 3. The economics behind prevention and health promotion ........................................................ 88
3.1. Redenen voor de stijging van kosten .......................................................................................... 89
3.2. wie is hier verantwoordelijk voor? .............................................................................................. 90
3.3. feel4diabetes ............................................................................................................................ 102
3.3.1. Doel van de studie ............................................................................................................. 103
3.3.2. de interventie..................................................................................................................... 104
4. Oefeningen ...................................................................................................................................... 113
4.1. Oefening 1 ................................................................................................................................ 113
