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3.2.3 Considerations

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Medical Technology and Evaluation

明尼苏达大学

4.4（147 個評分） | 8.3K 名學生已註冊

課程 4（共 5 門，医疗市场專項課程）

Innovations in medical technologies are one of the leading areas of economic growth in the world. Whether new technologies take the form of pharmaceutical, medical device, biotechnology, information technology of some combination of these innovations, the opportunities for both private enterprise and social welfare are substantial. However, these innovations are not without cost, and require reimbursement from either a privately or publicly financed health care delivery system to enter the marketplace. This course aims to provide knowledge of the concepts, data, and methodology required to critically evaluate new medical technologies in order to secure financial investment, reimbursement, and regulatory compliance objectives, such as FDA approval. The course is designed to provide understanding of the analytic tools needed to evaluate medical technologies. After completing this course, students will have the skills needed to: - Understand the reimbursement systems financing medical technology use. - Understand the role of government and regulatory agencies in the development and use of new medical technologies. - Identify a population to be served by a medical technology. - Use health care data to evaluate a medical technology. - Perform cost/benefit and cost/effectiveness analysis of a new technology.

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4.4（147 個評分）

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DK

Nov 15, 2016

I learned a lot from this course I am glad I was able to finish this class, thank you for the experience.

AA

Mar 16, 2019

very useful course, amazing explanation. I wish luck for every one learn it.\n\nthanks

從本節課中

The Elements of Medical Technology Assessments

In this module we will discuss a variety of types of medical technology evaluation approaches and the types of assessments. We will go into detail about the pros and cons of each type of assessment as a way to illustrate situations where one approach may be better than another. Finally, we will also cover the details of the two fundamental features of any evaluation: measuring costs and benefits.

3.2.1 Introductions to Costs7:07

3.2.2 Costing4:59

3.2.3 Considerations7:23

教學方

Eric Barrette
Director of Research

腳本

This is lesson 3.2.3 Unit Costs.

In the previous lesson, we briefly touched on the idea of a unit cost or

probably a price, at the end of the lesson.

In this lesson, we'll discuss a few more details and

considerations thinking about and using Unit Costs.

The first consideration, when thinking about unit costs,

applies to unit costs in the hospital setting.

It's important to remember that hospital charges

are not the same as hospital prices or costs.

A hospital charge is what the hospital lists as the charge for a service maybe

$200 for a surgery.

The price that's paid by Medicare of the insurers is likely less than

200 maybe that's 150, that would be the price of the service.

The cost of the service on the other hand is what it costs for

that hospital to actually provide or produce that surgery.

That maybe $125, that would mean that if

the insurer reimburses $150 for

what costs $125, the hospital makes $25.

In this sense, the unit cost that we'd be interested,

because it would be what applies to the patients, or

what the insurers would pay would be the price, not the charge, and not the cost.

Hospital charges can be adjusted to reflect costs by using the Medicare

cost to charge ratio found in the Medicare Cost Reports.

Although we're most interested in prices, costs are still a better approximation,

or a proxy for price, rather than charges.

Hospital prices for privately insured patients usually need to be calculated

using administrative claims data from a commercially insured population because

charges do not reflect directly the prices or

the cost of procedures and can lead to misleading results.

A second consideration is inflation, in other words, how prices change over time.

If we want to calculate prices over time, we could adjust for

that change in price over time using the consumer price index, or

we could more accurately adjust for the change in price over time

using the medical components of the Consumer Price Index.

The medical component is based specifically on medical care products and

services, rather than a collection of all products and services in the economy.

A third consideration for using unit costs,

is that of patient time and how to estimate a price for

patient time costs which don't usually have prices associated with them.

Patient time cost can be estimated by the wage rate

of the patients in the targeted intervention.

However, not all patients in the targeted intervention may have a wage rate.

Stay at home parents will have to have their wages imputed.

One way to do this is to find the age, gender, education,

labor experience of a housewife, if that is the person, and

we're trying to identify the price of the time cost for.

And then, impute the wage from our regression equation that estimates

the wages from all of these variables listed for the entire population.

Other groups of patients who won't necessarily have wages

are retired people or children.

Who may be receiving health care, but won't have wages that can be used to

estimate the time costs because they are not working, there's no productive time

cost that could be used to impute the wage like there is for stay at home parents.

However, there are time costs associated with leisure in a similar

approximation could be used to estimate the value of the wage based

on the value of leisure to retired individuals or children.

Another consideration, an example of wages or

prices that need to be imputed are those of informal caregivers.

Again, the approach is similar, so we'd find the age, gender,

education, labor experience of the informal caregiver population.

And impute the wage from a regression model

that estimates wages from all of the variables for

the entire population, not just the informal caregiver population.

In other words, this approach estimates

what the informal care giver would make if they were in the working population.

Now let's consider an example.

Suppose there's a person who has to stay home from her job as an attorney to care

for an ailing parent.

In this sense, this person is an informal caregiver, however they have a job.

In this case, we could use her actual wage rate as a proxy for

the unit cost, or price, of the informal care giving.

Finally, there's one more consideration about future costs.

We have discussed adjusting for inflation, but there is also a question of whether or

not to include future costs in the analysis at all.

Generally, future medical or healthcare costs should be included.

This is not a controversial practice if the costs that are included are associated

with the condition being treated by the intervention.

For example, cancer treatment today that prevents cancer growth or

cancer progression would include all costs

associated with preventing cancer in the future.

However, future medical or health care costs that are unrelated to

the intervention or condition that are being assessed are controversial.

These refer to any medical costs that would be included due to treating another

condition that resulted from treating the original condition.

For example, if we're trying to assess cancer treatments and

then include the cost of a heart attack.

Ten years from the start of the cancer treatment assessment because the person

lived for ten years after being treated for cancer rather than only five years.

It would be controversial to include the cost of the heart attack

in the assessment of the cancer treatment.

Although, there's no hard and fast rule about this and

it's up to the analyst to determine which costs to include.

Future costs generally should only include those associated with the condition or

intervention that's being assessed.

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