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48 Cards in this Set
- Front
- Back
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Relative Risk
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treatment risk/control risk
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Absolute Risk
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patients who had the outcome / who could have had an outcome
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Odds Ratio
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treatment odds/control odds
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odds
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patients who had an outcome / patients who didn't have the outcome
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Absolute Risk Reduction
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control risk - treatment risk
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Relative Risk Reduction
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[control risk - treatment risk] / control risk
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number need to treat to benefit
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NNT = 1/ARR
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Type 1 (alpha) error
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risk of finding through chance something in the sample that doesn't exist in population
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Type 2 (beta) error
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risk of missing through chance something that is present in the population
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confidence intervals
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how confident are we about whether the sample reflects the population value
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the 3 "dragons"
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cost
quality access |
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what does stevens think are the main contributors to cost?
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high tech
pharma |
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3 tiers
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purchaser --> payer --> provider
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current PMPM setup
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purchaser --> payer = PMPM
payer --> provider = fee for service |
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capitation
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providers are paid a set amount for each enrolled person per period of time
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how does risk currently flow?
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premium --> purchaser --> plan --> provider
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medical loss ration
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$$ in / $$ out
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RAND/UCLA appropriateness method
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procedure appropriate if medical benefits exceed medical risk
no dollars involved |
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Healthcare is what % of US GDP?
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17% (2.5 trillion in 2009)
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Admin is what % of healthcare spending?
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25%!! This is a big factor in US health spending
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What does Carlisle say is the main reason US healthcare spending is so high?
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PRICES
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What is the leading cause of personal bankruptcy in the US?
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paying for medical care
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What are PPACA's 3 main elements?
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1) Individual mandate
2) Insurance reform (ie. no recission) 3) Health care workforce |
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When do most PPACA changes kick in?
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2014
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we're the only the developed country that doesn't provide...
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some sort of universal coverage
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individual mandate
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law requires that you have health insurance --> pay a penalty if you don't
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what is a major source of how PPACA is getting funded?
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cutting medicare payments
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which state did an almost identical health care reform before PPACA?
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massachusetts
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who is responsible for quality?
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hospitals, physicians, health plans, nurses, etc
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efficacy
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ability of care to improve health
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effectiveness
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degree to which health improvements are realized
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efficiency
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ability to obtain greatest health improvement at lowest cost
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optimality
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most advantageous balancing of costs and benefits
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acceptability
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conformity to patient references
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legitimacy
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conformity to social preferences
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equity
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fairness in distribution of care and its effects on health
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7 pillars of quality
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efficacy
effectiveness efficiency optimalization acceptability legitimacy equity |
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how many deaths due to medical errors?
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100,000!
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quality problems
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1) underuse
2) overuse 3) misuse |
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value
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outcome/cost
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features of future medical models
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1) providers sharing risk
2) capitation (bundled payments) 3) working together (medical homes) 4) healthcare IT 5) evidence-based care |
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phases of new drug application trials
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1 = safety --> healthy volunteers
2 = efficacy --> small scale clinical trial 3 = large, multicenter clinical trial, double-blind, placebo controlled |
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time and cost of drug development
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8-12 years and 1 billion dollars
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serious drug reaction
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results in death, hospitalization, disability
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iatrogenic
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adverse effects resulting from medical treatment or advice
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nosicomal
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originating in a hospital
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akrasia
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the disconnect between moral cognition and moral action
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virtue
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bridge between knowledge and action
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