Cost-Effectiveness Analysis, Cost-Utility Analysis, and the Perfect Health Care
ID: 128893 • Letter: C
Question
Cost-Effectiveness Analysis, Cost-Utility Analysis, and the Perfect Health Care System
Please answer the following questions regarding cost-effectiveness analysis, cost-utility analysis, and the perfect health care system.
Give an original example of a situation in which cost-effectiveness analysis and cost-utility analysis would give you contrary results. Substantiate your answer.
Suppose you had the opportunity to organize the perfect healthcare system. Explain how you would organize the financing method, reimbursement method, mode of production, and physician referral procedure.
Initial Response: Initial responses should be no less than 200 words in length not including your reference(s) and supported by at least two references
Explanation / Answer
Cost effectiveness analysis and cost benefit analysis are two components of the science of decision making for health. Great strides have been made in CEA and CBA . This analysis helps identify neglected opportunities by highlighting interventions that are relatively inexpensive yet have the potential to reduce the disease burden substantially. The basic payments methods applicable in all types of healthcare are totally eight types,each method is defined by the unit of payments like per time period,beneficiary,recipient,episodes,day ,services,dollar of charges etc. The finance and reimbursement methods include common term such as capitation,fee for service,global payments and cost reimbursement. But financial risks gradually shifts from being primarily on providers when payments is per time period to being primarily on payers when payments is per dollar of charges. These methods are typically combined to balance risks and thus balance incentives between payers and providers. Many professional norms and business practices have to be established to mitigate undesirable incentives. Health care differs from many industries in that unit of payment remain variable and unsettled.
The first thing to be observed in any healthcare system is long waiting times and delay in care. It dissatisfies patient,medical staff and physicians,while increasing healthcare costs reducing potential income ad adversely affecting clinical outcomes. So this should avoided most of the time and physicians referral procedures should be well organised and focused on these problems. Creating referral agreements can solve these. Primary care speciality care referral agreement can begin to address problems of delay and long waiting time for appointments with referral specialists. These agreements can rationalise the referral process for patients and physicians alike. Develop referral guidelines which define the clinical conditions to be referred,develop a referral process,conduct an audit to determine whether the changes have actually improved the system.