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Health Economics

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Externalities

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Externalities refer to the costs or benefits of a transaction that affect third parties who are not involved in the transaction. In healthcare, positive externalities like vaccinations benefit society, and healthcare policy often uses subsidies to encourage these.

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Adverse Selection

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Adverse selection happens when there is an asymmetry in information between buyers and sellers, leading to higher-risk individuals being more likely to purchase insurance, driving up costs. This challenges healthcare policy to create mechanisms to prevent market failure.

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Opportunity Cost

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Opportunity cost is the value of the next best alternative foregone as a result of making a decision. In healthcare, it pertains to trade-offs, such as between spending on public health initiatives versus direct care services.

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Gross Domestic Product (GDP) and Healthcare

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GDP and healthcare refer to the portion of a country's economic activity (GDP) dedicated to healthcare spending. It's a critical indicator for policymakers to gauge the sustainability of healthcare financing and impact on the economy.

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Health Disparities

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Health disparities are differences in health outcomes and access to care among different population groups, often influenced by social, economic, or environmental factors. Policies aim to address these disparities to achieve equitable healthcare for all.

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Provider Incentive Models

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Provider incentive models are compensation structures that reward healthcare providers for achieving certain performance metrics, often tied to efficiency, patient outcomes, and cost savings. These models are integral to modern healthcare management strategies.

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Cost-Benefit Analysis (CBA)

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CBA is a process that compares the costs and benefits of health interventions to determine the best allocation of resources. It's crucial in healthcare policy to prioritize spending effectively based on the quantifiable outcomes of different decisions.

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Demand Elasticity

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Demand elasticity refers to the responsiveness of the quantity demanded of healthcare services to a change in price. Understanding elasticity helps policymakers predict how changes in cost-sharing, like co-pays, will influence health services utilization.

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Consumer-Driven Healthcare

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Consumer-driven healthcare is a model of health insurance that empowers individuals to make decisions about their healthcare based on quality and cost. It impacts policy by shifting focus toward patient choice, price transparency, and competition among providers.

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Universal Health Coverage (UHC)

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UHC refers to a healthcare system where all individuals have access to the health services they need without suffering financial hardship. It is a goal for many healthcare policies aiming at equity, access, and the protection of citizens from health-related financial risks.

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Supply Elasticity

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Supply elasticity measures the responsiveness of the quantity supplied of healthcare services to a change in price. Insights into supply elasticity help manage healthcare workforce and service availability as market conditions fluctuate.

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Incremental Cost-Effectiveness Ratio (ICER)

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ICER is a calculation used in health economics to compare the cost-effectiveness of different interventions. It's calculated as the difference in costs divided by the difference in benefits and helps policymakers determine value for money in healthcare.

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Equity in Healthcare

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Equity in healthcare refers to fairness in the distribution of health resources and services. Ensuring equity is a central goal in health policy reform, targeting equal access for people of different socioeconomic statuses, races, and geographic locations.

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Fee-for-Service (FFS)

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FFS is a payment model where providers are paid for each service they perform. This can lead to increased healthcare costs due to the incentive to provide more procedures. Healthcare management often seeks alternatives to encourage more cost-effective care.

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Moral Hazard

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Moral hazard occurs when individuals change their behavior in a riskier way because they are insulated from the consequences, such as when people have health insurance and may use more medical services. It's a consideration in designing insurance plans to balance access with overutilization.

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Capitation

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Capitation is a payment arrangement for health care service providers. They are paid a set amount per patient per period regardless of the amount of care the patient needs. This affects healthcare management by incentivizing cost control and prevention services.

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Healthcare Financing

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Healthcare financing refers to the management and allocation of funds to cover the costs of health systems. Policymakers study financing models to ensure sustainability, efficiency, and equitable access to healthcare services.

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Value-Based Care

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Value-based care is a healthcare model that incentivizes providers to offer the best care at the lowest cost, focusing on outcomes rather than volume of services provided. This approach to health management aims to increase patient satisfaction and improve health outcomes.

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Cost-Effectiveness Analysis (CEA)

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CEA compares the relative costs and outcomes of different courses of action. It aids in healthcare management by identifying interventions that provide the most significant health benefit per unit of cost, helping to optimize limited resources.

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Benchmarking

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Benchmarking in health economics involves comparing performance metrics of healthcare entities to standardize quality and efficiency. It drives healthcare management by identifying best practices and performance gaps for improvement.

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Health Technology Assessment (HTA)

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HTA is the systematic evaluation of properties, effects, and/or impacts of health technology. It provides critical information for healthcare management decisions about the adoption of new technologies and their reimbursement policies.

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Risk Pooling

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Risk pooling is a health financing technique where a group of individuals' health risks are combined to reduce the impact on any single member. It is fundamental to insurance programs and influences policy on insurance design and management.

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Managed Care

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Managed care is a system that integrates the financing and delivery of healthcare to control costs and maintain quality. Healthcare policy often promotes managed care models, including HMOs and PPOs, to streamline services and reduce waste.

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Critical Pathway

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A critical pathway is a standardized plan that outlines the optimal sequencing and timing of interventions by physicians, nurses, and other healthcare staff for a particular diagnosis or procedure. It aims to enhance quality of care and reduce costs.

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Quality-Adjusted Life Year (QALY)

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QALY is a measure that combines life expectancy with the quality of life during those years. It's a key metric used in health economics to assess the value of medical interventions and inform policy decisions regarding coverage and reimbursement.

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