Bai 3 [1] Danh Danh Gia Kinh Te

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  • Tng quan v cc phng php nhgi kinh t y t

    HH nnii-- 20072007

    KHOA Y T CNG CNGB MN KINH T Y T

  • McMc titiuuSau bi ging, hc vin c kh nng:

    Trnh by khi nim nh gi kinh t y t. Trnh by khi nim, c im v kh nng p dng

    ca 4 phng php nh gi kinh t y t Tnh ton v a ra quyt nh cho bi tp nh gi

    kinh t y t

  • nhnh gigi ll gg??Evaluation= Assessment of somethingEvaluation= Assessment of something

    Nhn nh s vt, hin tng l tt hay xu, t hay cha t

  • nh gi g lp hc ca chng ta ???

  • - u vo (Inputs): Tin, Ging vin, Hcvin, Thit b, Ti liu, Khc- Hot ng (Progress): C m bo

    CT? s bui ni dung?

    - u ra (Outputs): ? ngi c oto ? bi trnh by? bi kim tra

    - Kt qu (Outcomes): ? ngic o to c kin thc tt, ?p dng c vo thc t

    - nh hng (Impacts):Gp phn ci thin sc

    kho ngi dn

    Hot ng

    u vo

    u ra

    u ra ccht lng

    u ra kmcht lng

    Kt qu

    nh hng

  • nhnh gigi KinhKinh tt YY tt??nh gi v chi ph v kt qu ca cc gii php iutr, d n, chng trnh y t. Ch ph (costs)

  • Chi ph (Cost)ChiChi phph (gi(gi ththnh)nh) ll totonn bb ngungunn llcc ccnn thithitt ttoorara vv/ho/hocc cungcung ccpp mmtt ddchch vv nnoo

    Gi (Price)GiGi ccaa ddchch vv ll ss titinn mm ngngii muamua,, hohocc ngngiibbnhnh,, phphii trtr khikhi hh ss ddngng ddchch vv..

    Gi tr (Value)GiGi trtr ll khkhii ninimm nhnh gigi chch quanquan ccaa ngngii muamua,,hayhay ngngii ss ddngng ddchch vv yy tt hh nhnh gigi ddchch vv hhmuamua ngng gigi nn uu vv llmm chocho hh hhii lnglng nn mmccnnoo ((ttnhnh ccnn thithitt vv khkh nngnng chichi trtr))

  • nhnh gigi KinhKinh tt YY tt??nh gi v chi ph v kt qu ca cc gii php iutr, d n, chng trnh y t.

    Kt qu (Consequences)

    Effectiveness?

    Efficiency?

    Efficacy?

  • KtKt ququ trongtrong nhnh gigi trongtrong yy tt??

    Tngcng sckhongi dn

    S snphm tyu cucht lng

    S snphmc tora

    Tin dn,chngtrnh

    Ngnsch, conngi,trang thitb

    nhhng

    Kt quu raQu trnhthc hin

    u vo

    KtKt ququ

  • VaiVai trtr ccaa nhnh gigi KTYTKTYT

    Chi ph 1 Kt qu 1

    Phng n y t 1

    Chi ph 2 Kt qu 2

    Phng n y t 2

    nh giKinh tY t

    Quytnh

    C th so snh vi phng n l khng lm g!

  • HiHiuu ququ1.1. HiHiuu ququ hnhn2.2. HiHiuu ququ tngtng ngng3.3. KKmm hihiuu ququ hnhn4.4. ChaCha cc kktt lulunn

    ChiChi phphA.A. ChiChi phph ththpp hnhnB.B. ChiChi phph tngtng ngngC.C. ChiChi phph caocao hnhnD.D. ChaCha cc kktt lulunn

    BBii ttpp 1:1: ChChngng tata cc pp dngdng phphngng phphpp mmii iuiu trtr bbnhnh AA khkhngng nunu nhnh soso vvii phphngng phphppcc chchngng tata cc cccc ththngng tintin sausau::

  • HiHiuu ququ1.1. HiHiuu ququ hnhn2.2. HiHiuu ququ tngtng ngng3.3. KKmm hihiuu ququ hnhn4.4. ChaCha cc kktt lulunn

    ChiChi phphA.A. ChiChi phph ththpp hnhnB.B. ChiChi phph tngtng ngngC.C. ChiChi phph caocao hnhnD.D. ChaCha cc kktt lulunn

    B ?C ?

    1 2 3 4A ?

    D ? ? ? ?

    HiHiuu ququ((gigimm ii))

    ChiChi phph((tngtng lnln))

    = p dng PP miX = khng p dng PP miX= 2 pp nh nhau? = Cha bng chng kt lunk= Cn c s cn nhc thm

  • nhnh gigi kinhkinh tt yy tt

    M t chi phv kt qu

    M t kt quM t chi ph

    C xem xt n c chi ph v kt qu khng?

    CKhng

    nh gi KTYTy -CMA-CEA-CBA-CUA

    nh gi v kt quca phng n y t

    Phn tchchi ph

    C

    Ch quan tm nkt qu

    Ch quan tm nchi ph

    Khng

    C sosnh2 haynhiuphngn y tkhng?

  • nhnh gigi KinhKinh tt YY tt Phn tch chi ph ti thiu:

    CMA- Cost Minimization Analysis

    Phn tch chi ph hiu quCEA- Cost Effectiveness Analysis

    Phn tch chi ph li chCBA- Cost Benefit Analysis

    Phn tch chi ph tho dngCUA- Cost Utility Analysis

  • VV dd:: dd nn titimm chchngng mm rrngng

    1000 tr ctim mi

    30 triuTim nh k

    1000 tr ctim mi

    24 triuTim chin dch

    Kt quChi ph

    CMA

  • VV dd:: dd nn titimm chchngng mm rrngng

    1000 tr ctim mi

    30 triuTim nh k

    900 tr ctim mi

    24 triuTim chin dch

    Kt quChi ph

    CEA CER: Cost Effectivenness Ratio

  • VV dd

    141 triu60 triuDinh dng

    85 triu22 triuHIV/AIDS

    Kt quChi ph

    CBA BCR: Benefit Cost RatioNPV: Net Present Value

  • VV dd:: CaoCao HA /100HA /100 ngngi/ni/nmm

    70 QALY15 triuPhng php B

    60 QALY10 triuPhng php A

    50 QALY0Khng iu tr

    Kt quChi ph

    QALY : s nm sng c iu chnh theo cht lng cuc sng

  • VV dd:: TT caocao HA /100HA /100 ngngi/ni/nmm

    CUA Chi ph /QALY tng thm70 QALY15 triuPhng php B

    60 QALY10 triuPhng php A

    50 QALY0Khng iu tr

    Kt quChi ph

  • CCcc cpcp nhnh gigi KTYTKTYT

    HiHiuu sutsut kk thuthutt

    HiHiuu sutsut phphnn bb

    GiGiii phphpp AAhayhay BB cc hihiuuququ hhnn khikhigigiii quytquyt vnvn XX ??

    GiGiii phphpp AAgigiii quytquyt vnvn XX hayhay BBgigiii quytquyt vnvn YY

  • ChChnn thuthucc AdalatAdalat hayhay NifedipineNifedipine iuiu trtrcaocao huythuyt pp

    HuyHuynn AA cc nhiunhiu bbnhnh ARI vARI v bbnhnh SuySuy dinhdinhddngng,, ss tintin chch ththcc hihinn mmtt dd nn nnnn

    phphii chchnn 11

  • CMA, CEA, CBA, CUACMA, CEA, CBA, CUA

    CERn v tnhin

    TinCEA

    CP/QALY tng thm,CP/DALY gim i

    QALY, DALYTinCUA

    BCRNPV

    TinTinCBA

    Nh nhauTinCMAChCh ssKtKt ququChi phChi phP.phP.phpp

  • CMA, CEA, CBA, CUACMA, CEA, CBA, CUA

    SS 2 hoc nhiu CT ccng m.tiuHiu sut KT

    V t nhinTinCEA

    Ch.lng c.sngHiu sut KT, PB

    QALY,DALYTinCUA

    CT c li?Cc lnh vcHiu sut phn b

    TinTinCBA

    Cng kt quHiu sut KT

    Khng quantm

    TinCMApp dngdngKtKt ququChi phChi phP.phP.phpp

  • BBii ttpp::

    CCcc BSBS uu tt vvoo muamua mmyy sisiuu mm chocho phphngngkhkhmm-->> nn nnmm nnoo hh bbtt uu cc llii nunu nhnh::

    -- ChiChi phph muamua mmyy vvoo uu nnmm ll 300300 tritriuu ngng-- ChiChi phph vvnn hhnhnh mmyy mmii nnmm ll 2020 tritriuu ngng ((cucuiinnmm))-- LLii chch dodo mmyy sisiuu mm nnyy emem llii mmii nnmm ll 100100 tritriuu((cucuii nnmm))

    TT ll chitchit khukhu hhngng nnmm ll 7%7%

  • Cng thc

    FnPv= -----------

    (1 + r)a

    Pv l gi tr ti thi im hin tiFn l gi tr ti thi im n (thng l nm n)r l t l chit khu (li sut hng nm)a l khong cch thi gian t thi im hin tin thi im n (thng l s nm)