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HES - 3 - Justice Flashcards | StudBud
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HES - 3 - Justice
Measures wider utility
What are the principles of the NHS
HES - 3 - Justice
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1
What are the principles of the NHS
Comprehensive - range of services
Equitable - responds to needs and preferences
Universal - clinical need, not ability to pay
High quality - minimise errors
2
Measures wider utility
Cost Utility Analysis
Cost Consequence Analysis
Cost Benefit Analysis
Cost Effectiveness Analysis
3
What do the theories of distributive justice represent
How you treat patients
How you distribute resources to ensure equity
4
Consequences avoided by choosing to deploy resources in one way rather than another
Cost Benefit Analysis
Cost Effectiveness Analysis
Cost Utility Analysis
Cost Consequence Analysis
5
Patient decision as advanced statement (not legally binding) or advanced decision to refuse treatment (legally binding)
Lasting power of attorney
Court of protection
Advanced directive
Doctor
6
Examples of allocation based on need
Degree of ill health
Ability to benefit
Presence of chronic disease
Clinical need
7
1 cancer treatment = 1000 vaccines
Cost Consequence Analysis
Cost Benefit Analysis
Cost Utility Analysis
Cost Effectiveness Analysis
8
Everyone gets the same
Libertarian
Egalitarian
Socialist
Meritocratic
9
Examples of health and social services resource use
Home adaptation
A&E
GP
Staff wages
10
What are the domains of NHS care
Ensure positive patient experience
High quality
Treat in safe environment and protect from avoidable harm
Centrally funded
11
Refuse life-saving treatment
Advanced statement
Advanced decision to refuse treatment
12
Good choices result in good consequences
Just world hypothesis
Double jeopardy
Horizontal equity
Vertical equity
13
What is technical efficiency?
Can be tested and proved
Most benefit per cost (Most beneficial per cost)
Meeting objective at least cost (Cheapest)
Opinion based
14
Cost per unit benefit
Cost Benefit Analysis
Cost Consequence Analysis
Cost Utility Analysis
Cost Effectiveness Analysis
15
Overview of technical efficiency?
Produce output/treat so best satisfies pattern of patients' wants or needs
Resources are allocated if certain objectives are achieved
Predicting observable factors provides information and benefits
Produce an output in the best way possible without wasting resources
16
Those already disadvantaged find themselves further disadvantaged
Just world hypothesis
Double jeopardy
Horizontal equity
Vertical equity
17
What are the protected characteristics of the Equality Act 2010
Gender Reassignment
Income
Sexual orientation
Sex
18
What are the advantages of cost effective analysis
Easily understood
Dependent on individual
Consider quality and quantity of life
Used in clinical studies
19
Treat according to differential need
Horizontal equity
Double jeopardy
Vertical equity
Just world hypothesis
20
What do the types of justice represent
How you distribute resources to ensure equity
How you treat patients
21
Treats patients according to how deserving they are
Justice as maximising utility
Formal justice
Substantive justice
Justice as dessert
22
Assesses single clinical outcome, measures health
Cost Effectiveness Analysis
Cost Utility Analysis
Cost Consequence Analysis
Cost Benefit Analysis
23
What are some dimensions of QoL
Pain/discomfort
Mobility
Self care
Anxiety/depression
24
Maximum benefit for most people
Justice as maximising utility
Justice as dessert
Substantive justice
Formal justice
25
Examples of wider cost implications to society
Staff wages
Drinking
Groceries
Loss of productivity due to people not being able to go to work
26
Dependent on cheapest procedure
Cost Effectiveness Analysis
Cost Utility Analysis
Cost Minimisation Analysis
Cost Benefit Analysis
27
Choose behind veil of ignorance
Fairness
Meritocratic
Libertarian
Socialist
28
What is normative stance?
Most benefit per cost
Meeting objective at least cost
Opinion based
Can be tested and proved
29
Examples of costs incurred by patients and carers
Time and transport
Groceries
Over the counter meds
Staff wages
30
Everyone gets what they deserve
Socialist
Meritocratic
Libertarian
Fairness
31
Mental Capacity Act 2005
Unwise decisions don't indicate incapacity
Invasiveness
Least restrictive
In patient's best interest
32
Acts in best interest of patients
Advanced directive
Court of protection
Lasting power of attorney
Doctor
33
What are the disadvantages of cost effective analysis
Lack of compatability
Dependent on individual
Only intermediated and single outcome
Easily understood
34
Assessment of capacity - Test of capacity
Ability to understand and retain information
Ability to understand, retain, weigh up and communicate information
Ability to understand, retain and weigh up information
Ability to understand information
35
Overview of positive stance?
Produce output/treat so best satisfies pattern of patients' wants or needs
Resources are allocated if certain objectives are achieved
Predicting observable factors provides information and benefits
Produce an output in the best way possible without wasting resources
36
Cost per unit effect
Cost Effectiveness Analysis
Cost Consequence Analysis
Cost Utility Analysis
Cost Benefit Analysis
37
What are indirect costs
Wider cost implications to society
Staff wages
Health and social services resource use
Costs incurred by patients and carers
38
(Cost Benefit Analysis) If the cost is between £20,000-30,000 per QALY, NICE will recommend for which criteria
Disadvantaged populations
Aliens
Rich people
Cancer drug funds
39
Equal treatment of people equal in relevant respect
Double jeopardy
Horizontal equity
Vertical equity
Just world hypothesis
40
To each according to their need
Socialist
Fairness
Libertarian
Meritocratic
41
Mental Capacity Act 2005
Diagnostic test
Practical steps aid decision making
Gives autonomy
Assumes capacity
42
What is allocative efficiency?
Can be tested and proved
Opinion based
Meeting objective at least cost (Cheapest)
Most benefit per cost (Most beneficial per cost)
43
Dependent on income dedicated to health
Libertarian
Fairness
Socialist
Meritocratic
44
Patient's wishes and preferences in treatment they want to receive
Advanced statement
Advanced decision to refuse treatment
45
What are the advantages of cost utility analysis
Consider quality and quantity of life
Easily understood
Used in clinical studies
Dependent on individual
46
What are the protected characteristics of the Equality Act 2010
Disability
Housing
Pregnancy and maternity
Marriage or civil partnership
47
Values trivial diseases more
Substantive justice
Justice as maximising utility
Formal justice
Justice as dessert
48
(Cost Benefit Analysis) If the cost is <£20,000 per QALY, NICE is likely to...
Recommend
Not recommend
49
What are the types of economic evaluation other than cost minimisation analysis
Cost Utility Analysis
Cost Benefit Analysis
Cost Consequence Analysis
Cost Effectiveness Analysis
50
(Cost Benefit Analysis) If the cost is between £20,000-30,000 per QALY, NICE will recommend for which criteria
Significant innovation
End of life care drugs
Ultra-orphan drugs (Rare diseases)
Children
51
Cost per QALY (measures QoL)
Cost Utility Analysis
Cost Consequence Analysis
Cost Effectiveness Analysis
Cost Benefit Analysis
52
Substituted decision making by health/social welfare
Advanced directive
Doctor
Court of protection
Lasting power of attorney
53
What is economic evaluation?
Comparative analysis of alternative courses of action - costs &consequences
Comparative analysis of effectiveness of processes or procedures
54
Fairness-based
Justice as dessert
Justice as maximising utility
Formal justice
Substantive justice
55
Overview of allocative efficiency?
Produce an output in the best way possible without wasting resources
Resources are allocated if certain objectives are achieved
Produce output/treat so best satisfies pattern of patients' wants or needs
Predicting observable factors provides information and benefits
56
What are direct costs
Health and social services resource use
Wider cost implications to society
Costs incurred by patients and carers
Staff wages
57
What is positive stance?
Most benefit per cost
Opinion based
Meeting objective at least cost
Can be tested and proved
58
Maintains existing inequalities
Justice as maximising utility
Justice as dessert
Formal justice
Substantive justice
59
Uses cost-utility ratio
Cost Effectiveness Analysis
Cost Consequence Analysis
Cost Benefit Analysis
Cost Utility Analysis
60
Takes into account inequalities
Justice as maximising utility
Substantive justice
Formal justice
Justice as dessert
61
Overview of normative stance?
Produce output/treat so best satisfies pattern of patients' wants or needs
Predicting observable factors provides information and benefits
Produce an output in the best way possible without wasting resources
Resources are allocated if certain objectives are achieved
62
What are the domains of NHS care
Enhance QoL for chronic patients
Prevent premature death
Aid recovery for ill health or injury
Free at point of delivery
63
Allocation based on need
Justice as satisfying cost
Fair justice approach
Justice as satisfying need
Fair innings approach
64
Addresses technical efficiency
Cost Utility Analysis
Cost Effectiveness Analysis
Cost Benefit Analysis
Cost Consequence Analysis
65
What are the disadvantages of cost utility analysis
Used in clinical studies
May discriminate elderly
Dependent on individual
Insensitivity of questionnaires
66
Uses Aristotle's formal principal
Justice as maximising utility
Substantive justice
Formal justice
Justice as dessert
67
What are the principles of the NHS
Centrally funded
Prevent premature death
Free at point of delivery
Enhance QoL
68
Assessment of capacity - Diagnostic test
Does the disorder influence their decision making
What's the timeframe
Do they have a disorder
Is the disorder recoverable
69
Values years of life remaining
Justice as satisfying need
Fair innings approach
Justice as satisfying cost
Fair justice approach
70
Can make legal decisions - appoint deputy, urgent/emergency situations
Lasting power of attorney
Advanced directive
Doctor
Court of protection
71
What are the stances on economic status?
Normative stance
Positive stance
Normal stance
Negative stance
72
Types of cost of intervention
National costs
Indirect costs
Direct costs
Local costs
73
What are the protected characteristics of the Equality Act 2010
Religion (belief or lack thereof)
Race
Nationality
Age
