final exam health ecnomimc - copy

8/2/2019 Final Exam Health Ecnomimc - Copy

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1- A2 -B3 -B4- C

5 -D6 -B

2.A study published in BMC Health Services Research in October 2008 considered thecost-effectiveness of assisting general practitioners in management of patients with diabetes

by use of a centralized database of clinical data to coordinate care. Based on five years ofdata a simulation model was used to predict patient outcomes and complications up to thetime of death.

The per patient increase in costs due to the program were estimated to be $3,000. Expectedlife-years (from start of the program and discounted at 5%) were calculated to be 11.3 yearsfor those in the program and 10.9 if not in the program. For quality-adjusted life years thecomparable figures were 8.5 and 8.2. A year of perfect health is felt to be worth $50,000.

)a) Perform a cost-benefit analysis of the program. What do you conclude?

Marginal benefit is 50,000 (8.5 8.2) = 50000 0.3 = $15,000.Marginal cost is $3,000. Conclude that program is worthwhile as MB > MC.

)b) Perform a cost-effectiveness analysis of the program. What do you conclude?

Cost per QALY is 3000 / (8.5 8.2) = 3000 / 0.3 = $10,000. This is quitelow, and less than $50,000. Conclude that program is worthwhile.

(c) Consider the following screening test for cancer applied to 100,000people of who 100 have cancer. Each test costs $5, picks up 80% ofcancer cases, and additionally 10% of the time falsely diagnosescancer. Detection of cancer (rightly or wrongly) leads to a further exactdiagnostic test that costs $100. Correct early detection of cancer bythe test is valued at $10,000. Is the first test worthwhile?

Marginal benefit: Detect 0.8 100 cases = 80 cases at $10,000 each= $800,000. Marginal costs: Direct = 100,000 $5 = $500,000.Indirect: 80 true cases plus 10,000 false positive (0.1 100,000) =10,080 $100 = $1,008,000. Not worthwhile as MB = $800,000 lessthan MC = $500,000 + $1,008,000 = $1,508,000.


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3- Show on the graph below the consumer and producer surplus, andcalculate the producer and consumer surplus.

C: - consumer surplus

H: - producer surplus

Consumer surplus :- ( base * height) / 2 = ((40-0) * (3600-2000)) / 2 =32,000 $

Producer surplus :- ( base * height) / 2 = ((40-0) * (2000-400)) / 2 =32,000 $


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4- Explain the advantage and disadvantages of different type of insurance,what type of health do you recommend for Palestinian in the occupiedterritories, why?

private health insurance Manage by private sector, voluntary health insurance system, premium is according to the needed health services, depends on purchasing the health services.

social health insurance system Manage be independent agency, mandatory for all society member, the premium is a percentage out of the personal income,

provides all health services depending on purchasing thehealth services, health service basket include all essential services with abilityfor external referral.

tax health insurance system : managed by the government, mandatory for all citizens, monthly premium is a percent of the income, availability of for external referral system, depend on the principle of purchasing the health services.

I think social health insurance is good for Palestinian population, b\c it givepercentage of income, also it sustain system for long time, b/c payment ofhigh income people to lower income can maintain the payment for healthcare sysytem, also it achieve equity.

Also we add private health insurane, b/c high income people may refuse totake health care from govermental hospital as lower income people dp, alsolow income people dont have enough money to go for private health

insurance.


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5- What are the causes of market failure in health care, explain? Whatrecommendation you can provide to improve equality while maintainingreasonable cost and quality?

1- Uncertainty2- Externalities3- Asymmetric of knowledge.4- Consumer rationality and consumer sovereignty,5- Competition and barriers to market entry,6- Economics of scale and monopoly,

My recommendation is:To go with iedeal condition of market which is certainty, no Externalities,perfect knowledge, consumer act free of self-inrtest, svseral smallsuppliers to promote genuine competition.

final exam health ecnomimc - copy

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