SEMINAR

ON

HEALTH ECONOMICS
&
HEALTH TECHNOLOGY

SUBMITTED TO: SUBMITTED BY:

Mrs.Merlin Rajakumari S.Prashanth raj

Associate Professor M.Sc Nursing 1st year

Dept of CHN CHN

CON , PIMS. CON , PIMS.

SUBMITTED ON:

15.06.2021

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INDEX

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S.NO CONTENT PAGE.NO
01 HEALTH ECONOMICS
i. Introduction 01
ii. Health 01
iii. Economics 01
iv. Health economics 01
v. Aim of health economics 01
vi. Principles of Health Economics 01-03
vii. Economic analysis 03-05
viii. Benefits 06
IX. Major problems in health financing 07
x. Role of nurse in health economics 07-08
02 HEALTH TECHNOLOGY
 Technology 08
 Health technology 08
 Purpose 08
 Areas of health technology can be formulated 09
 Health technologies are essential when they 09
 Basic health technology assessment Orientations 10-11
 Ten basic steps of health technology assessment 11
 Health Technology Assessment Programme (HTAP) 12
 Health technology and decision making 13
 Properties and impact assessed 13
 Utilization of health technology 13
 Benefits of health technology 13
03 Summary 13
04 Conclusion 13-14
05 Journal abstract 14-15
05 Reference 15-16

SEMINAR CONTENT

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 Subject Community Health Nursing -I
Unit II - Health
Topic Health economics and Health technology.
Method of Teaching Lecture cum Discussion
AV Aids Power point presentation, chart, pamphlet, whiteboard,
handouts, flannel graphs
Date
Time

Objectives

General objectives

Through this the student will be able to develop in-depth knowledge on health
economics and health technology , apply this knowledge in providing health care services in
the community with desirable attitude effectively.

Specific objectives
At the end of the teaching the student will be able to:
 Define health economics
 Describe the Aims of health economics
 List the types of economic analysis in health
 Mention some major problems in health financing
 Discuss Role of nurse in health economics
 Define health technology
 State the purpose of health technology
 Discuss the Areas of health technology can be formulated
 Describe health technology assessment
 Classify basic health technology assessment orientation
 List down the Ten basic steps of health technology assessment
 State the health technology assessment program
 Interpret the health technology and decision making
 Enlist the benefits of health technology

HEALTH ECONOMICS

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Introduction

Health economics generally deals with the purpose and planning of budgeting which
is required to be done in the health care delivery system for providing care.

Health

Health is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity.

Economics

It has been variously described as the study of wealth, study of welfare and study of
scarcity.

Health economics

It is the discipline that determines the price and the quantity of limited financial and
nonfinancial resources devoted to the care of the sick and promotion of health.

Aim of health economics

a) To quantify overtime the resources used in health service delivery.

b) To organize, allocate and manage the resources.

Principles

Health economics works on two principles:

a) Microeconomics
b) Macroeconomics
 Microeconomics

It deals with the behaviors of the individuals and organizations and the effects of those
behaviors on prices, costs, and the allocating and distributing resources.

It has following factors:-

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 Supply and demand

Factors

Effectiveness Efficiency

a. Supply and demand:

These both factors are interrelated to each other because if there is no demand
then there is no supply, but if there is good demand then there is a good supply and the cost
of demanding objects will be higher.

b. Efficiency:

It refers to producing maximal output, such as good or services, using a given

set of resources, such as labor, time, and money.

c. Effectiveness:

It refers to the extent which a health care services meets a stated goal or
objective, or how well a program or service.

 Macroeconomics

It deals with the large- scale or general economic factors, such as interest rates
and national productivity.

It has two factors:-

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 Gross National Gross Domestic
FACTORS Product
Product

GNP & GDP:

----------------The National Product and Gross Domestic Product are the conventional terms
used to understand the performance of the economy.

These indicate the sum total of three components in a country:-

a. Personal consumption
b. Expenditure of goods and services
c. Investment expenditure.

GNP & GDP serves as measures of total production of goods and services in a country during
year.

Economic analysis:

Types of economic analysis in health:

Cost
minimization
Cost Cost benefit

ECONOMIC Cost
Poverty line
ANALYSIS effectiveness

Demand Cost utility

Scarcity

a) Cost- minimization:

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 In this the inputs are compared and outputs are considered to be equal, which rarely
so.

b) Cost benefit:

In this type of analysis all outputs are measured in monetary terms.

c) Cost effectiveness:

Here a clinical output such as morbidity, mortality, reduction in blood pressure, or

quality of life, etc. is measured as a measure of the effectiveness.

d) Cost utility:

This measure allocation of resources and utilization of the consumers.

e) Scarcity:

Scarcity exists to all walks of life. The health needs are infinite whereas the resources

are definitely limited, in India as elsewhere.

f) Demand:

It is, the type, quantity and quality of services or commodities wanted or requested.

But the demand for health and medical care in strict economic sense, is a function of:

 Consumer’s income,
 The price of medical care relative to the prices of other goods,
 Preferences of consumers, including their perceptions about health and health care.
g) Poverty Line:

Poverty line refers to, the cutoff point of income below which people are not able to purchase
food sufficient to provide 2400 kcal per head per day.

h) Cost:

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It refers to the resources which are spent in carrying out health activities so far as the health
care sector is concerned.

In general, costs can be classified into two broad groups:-

1. Capital costs:
These costs are borne irrespective of the workload of any health center and are
fixed. These may include- Building, i.e. the health center, hospital.

2. Operating costs:
These costs are related to the level or type of activity in a health institution. Some
operating costs will change daily and some from year to year.

These operating costs include:

 Salaries, wages and allowances of health staff at different levels.
 Medical supplies, drugs etc.
 Transport operating costs.
 Maintenance and repairs.
 Training.
 Power.
 Other miscellaneous items.
3. Factors:
Historical Perspectives
Until 1930, the predominant method of health care functioning was private payment.
Physicians charged a fee for the services they rendered and the patient paid these out-
of-pocket expenses.In the year 1929, the concept of paying small fee for guaranteed
health care became popular through the
Use of health care:
As the financial funding process emerged the use of health care and services also
increased.
Health behaviors: Due to increased awareness toward health, more peoples are
demanding preventive health care from the provider and their health care contractors.
Public financing of health care has increased funding for such preventive care as
screening tests, periodic examination, and immunization.

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 Technology advances: Modern society has become to expect miraculous technological
advances. Now 50% of the population consuming 80% of the health care resources.
4. Benefit:

The benefits of health program or project are the desired effects of the program.

Cost Benefit Cost-

Analysis Benefit effective
(CBA) Analysis

 Cost Benefit Analysis(CBA):

It is an economic technique applicable to-

 Health planning,
 Health management, and
 Evaluation,

Which scheme or combination of schemes will contribute most to achievement at a fixed

given investment.

 Cost- effective Analysis:

It is formal planning and evaluation technique having both economic and

technical component.

It involves organizing information so that the costs of alternatives and their

effectiveness in meeting a given objective can be compared systematically.

i.Budget

The budget is a systematic economic plan for a specific period of time.

It incorporates politically and technically determine in what way and for what purpose
various health resources are to be used.

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 ii.Health Financing

It refers to the raising of resources to pay for goods and services related to health.
These resources may be in the form of “cash” or “kind”.

MAJOR PROBLEMS IN HEALTH FINANCING

 Lack of funds.
 Unequal distribution of health finances.
 Rising health costs.
 Lack of coordination of health financing units.
 Wastage and in sufficiency in spending the funds or resources available.

Public financing of health care:

The social security act created Medicare and Medicaid respectively.

Medicare:

It was intended to provide health care to the growing population of those 65 years of
age and older.

Medicaid:

 It provides universal health care coverage for the indigent and children.
 Priority participation is given to children, pregnant women, and the disabled.

Role of nurse in health economics:

 Nurses play a central role in cost containment, care quality, and patient safety.
 Nurses actively engages in leading efforts to improve patient care and reduce costs.
 Health care Issues and Trends
 Governing on Behalf of Stakeholders.
 Monitoring Financial Performance.
 Building a Culture of Quality and Safety.
 Monitoring Quality Performance.

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  Set policy that guides care delivery.
 Set strategy to help ensure the future health of a vital community resource.
 Assume a valued community leadership role.
 Help the boards identify, clarify, and focus on the wants and needs of the patients.
 Share patient needs and concerns and ensure.

HEALTH TECHNOLOGY

Technology
The branch of knowledge that deals with the creation and use of technical means and
their interrelation with life, society, and the environment, drawing upon such subjects as
industrial arts, engineering, applied science, and pure science.

Health technology

 It is the prevention and rehabilitation, vaccines, pharmaceuticals and devices, medical

and surgical procedures, and the systems within which health is protected and
maintained.
 Health technologies are used at every level of the health care system from the simplest
to the most advanced.
 They form the backbone of the services medicine can offer in the prevention, diagnosis
and treatment of illness and disease.

Purpose
a) Develop and maintain basic operational frameworks for safe and reliable health
services and technologies.
b) Help Member States complete the basic operational frameworks through project
proposals prepared by Member States.
c) Develop norms and standards, guidelines, training materials, reference materials and
estimation of burden of disease.
d) Focus on diseases of the poor.
Areas of health technology can be formulated:

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Health technologies are essential when they

a) Meet basic needs for health services
b) Have been proven to be cost-efficient
c) Are evidence-based
d) Health technologies are evidence-based when they meet well-defined
e) specifications and have been validated through controlled
f) clinical studies or rest on a widely accepted consensus by experts

Health Technology Assessment (HTA)

Health technology assessment is the systematic evaluation of properties, effects or other

impacts of health technology.

The main purpose of HTA is to inform policymaking for technology in health care, where
policymaking is used in the broad sense to include decisions made at, e.g., the individual or
patient level, the level of the health care provider or institution, or at the regional, national
and international levels.

Basic health technology assessment Orientations

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 Technology-
oriented
assessments

BASIC HTA
ORIENTATIONS

Project- Problem-
oriented oriented
assessments assessments

Technology-oriented assessments: -
 These are intended to determine the characteristics or impacts of particular
technologies.
 For example, a government agency may want to determine the clinical, economic,
social, professional, or industrial impacts of population based cancer screening,
cochlear implants, or other particular interventions.

Problem-oriented assessments:-
 It focuses on solutions or strategies for managing a particular problem for which
alternative or complementary technologies might be used.
 For example, clinicians and providers concerned with the problem of diagnosis of
dementia may call for the development of clinical practice guidelines involving some
combination or sequence of clinical history, neurological examination, and diagnostic
imaging using various modalities.

Project-oriented assessments:-
 It focus on a local placement or use of a technologyin a particular institution,
program, or other designated project.

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  For example, this may arise when a hospital must decide whether or not to purchase a
magnetic resonance imaging (MRI) unit, considering the facilities, personnel, and
other resources needed to install and operate an MRI unit; the hospital's financial
status; local market potential for MRI services; competitive factors; etc.

Ten basic steps of health technology assessment

There is great variation in the scope, selection of methods and level of detail in the practice
of health technology assessment. Nevertheless, most HTA activity involves some form of the
following basic steps.

Identify
assessment
topics
Specify the
Monitor
assessment
impacts
problem

Disseminate Determine
findings and locus of
recommenda- assessment
tions

STEPS OF
HTA

Formulate
findings and Retrieve
recommendatio evidence
ns

Integrate/ Collect new

primary data
synthesize (as
evidence Appraise/ appropriate)
interpret
evidence

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Health technology assessment programme (HTAP)
HTA is an innovative program that determines if health services used by state government are
safe and effective.
The primary goals are to make:
a) Health care safer by relying on scientific evidence and a committee of practicing
clinicians.
b) Coverage decisions of state agencies more consistent.
c) State purchased health care more cost effective.
d) Coverage decision process more open and inclusive by sharing information, holding
public meetings, and publishing decision criteria and outcomes.

EXPERTISE FOR CONDUCTING HTA:-

Depending upon the topic and scope of assessment, these may include a selection of the
following:
 Physicians, nurses, dentists, and other clinicians
 Managers of hospitals, clinics, nursing homes, and other health care institutions
 Radiology technicians, laboratory technicians and other allied health professionals
 Biomedical and clinical engineers
 Pharmacologists
 Patients and patient affairs representatives
 Epidemiologists
 Biostatisticians
 Economists
 Lawyers
 Social scientists
 Ethicists
 Decision scientists
 Computer
 scientists/programmers
 Librarians/information specialists.

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Health technology and decision making
 Health technology has the tremendous potential to change our understanding of
disease, transform the delivery of healthcare services, and improve health outcomes.
But using such technology comes at a price.
 Decisions about whether to purchase and use new technology should be based on
high-quality evidence on its impact on health care and health outcomes.
 Health Technologies and Decision Making analyses the barriers to, and facilitators of,
evidence-based decision making in health-care systems
Properties and impact assessed
In general, these include the following.
a) Technical properties
b) Safety
c) Efficacy and/or effectiveness
d) Economic attributes or impacts
e) Social, legal, ethical and/or political impacts
Utilization of health technology
a) Improve health care quality
b) Prevent medical errors
c) Less paper work
d) Reduce health care cost
e) Expand access to affordable care
Benefits of health technology
a) Early detection of burden of disease
b) Evaluate the health care services to see the cost benefit of the health care services
c) Improving to tracking of chronic disease management

summary
Health economics is concerned with issues related to efficiency, effectiveness, values, and
behavior in the production and consumption of health and health care.

Conclusion

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The Health Care Finance Administration today must react expeditiously to rapid advances
and changes made in medical science and technology and define and clarify the benefits
under the Medicare program. This is a challenge because, like all health plans, Medicare
often faces the dilemma of having inadequate data to make evidence-based coverage
decisions for new technologies and services. Agency for Health Care Policy & Research thus
plays a crucial role in providing needed information on medical effectiveness and outcomes,
which assists in the adoption of appropriate coverage policies. This, in turn, serves
beneficiaries by assuring

Journal :
1. The Economics of Public Health: Missing Pieces to the Puzzle of Health System
Reform
The United States continues to experiment with health care delivery and financing
innovations, but relatively little attention is given to the public health system and its
capacity for improving health status in the U.S. population at large. The public health
system operates as a multisector enterprise in which government agencies work in
conjunction with private and voluntary organizations to identify health risks in the
population and to mobilize community-wide actions that prevent and contain these risks.
The Affordable Care Act and related health reform initiatives are generating new interest in
the question of how best to expand and integrate public health approaches into the larger
U.S. health system. The research articles featured in this issue of Health Services Research
cluster around two broad topics: how public health agencies can deliver services efficiently
and how public health agencies can interact productively with other elements of the health
system. The results suggest promising avenues for aligning medical care and public health
practices.

2. New technologies, new disparities: The intersection of electronic health and digital
health literacy
Mobile health, or mHealth, is the implementation of digital health services with mobile
and wearable devices, and has ample potential to enhance self-management of chronic
conditions, especially cardiovascular risk factors (e.g., blood pressure control and
supporting tobacco cessation and physical activity). It remains ambiguous, however,
whether such technologies can improve cardiovascular outcomes. More importantly,

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 mHealth carries the additional challenge of digital health literacy, which demands particular
skills complementary to general and health literacy. Populations at risk for limited health
literacy are similarly vulnerable to having challenges with digital health literacy. We
identify such challenges and outline solutions to improve access to digital health services
and their use for individuals with limited digital health literacy. We present an 18-point
"Digital Universal Precautions" as a mandate for health care organizations committed
towards addressing and facilitating eHealth literacy. As health care institutions increasingly
advance mHealth through delivery of on-line material and patient portals, they face the
challenge of ensuring that digital health services and content are available to all patients.

Bibliography:

Book reference:
1. Park. K "PREVENTIVE AND SOCIAL MEDICINE" 19" edition (2012); Bhanot
Publishers.
2. Las S. Textbook of Community Medicine, Preventive and Social Medicine. Fifth edition.
New Delhi, India. CBC Publishers & Distributers Pvt ltd. 2017
3. Kishore J.National Health Programes of India- National policies and Legislations
Relayed to health, Twelfth Edition, New Delhi, India, Century Publications, 2017.
4. Philips CJ. Health Economics an introduction for health professionals. Massachusetts,
USA. Blackwell Publicating Inc.2005

Net reference:
1. https://www.slideshare.net/ancychacko89/health-economics-44873042
2. https://www.slideshare.net/pramodkumarsikarawar/health-economics-66624998
3. https://www.slideshare.net/aparnachaudhary7/concepts-in-health-economics
4. https://www.slideshare.net/pramodkumarsikarawar/health-technology-66625003
5. https://www.slideshare.net/drjayeshpatidar/health-technology
6. https://www.slideshare.net/Biomoda/healthcare-and-information-technology

Journal reference:
1. Mays, G. P., Atherly, A. J., & Zaslavsky, A. M. (2017). The Economics of Public
Health: Missing Pieces to the Puzzle of Health System Reform. Health services research,
52 Suppl 2(Suppl 2), 2275–2284. https://doi.org/10.1111/1475-6773.12782.

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2. Smith, B., & Magnani, J. W. (2019). New technologies, new disparities: The intersection
of electronic health and digital health literacy. International journal of cardiology, 292,
280–282. https://doi.org/10.1016/j.ijcard.2019.05.066.

THANK YOU

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