Health Economics Practice Questions

Q: In a programme, analysis of results in comparison to cost is known as

Cost benefit analysis. ***Cost benefit analysis*** - In **cost-benefit analysis**, the **benefits of a program** are quantified in monetary terms and then compared directly with the **monetary cost** of the program. - This method is used to determine if the **monetary gain (or benefit)** from a program outweighs its monetary expenditure. *Cost effective analysis* - **Cost-effectiveness analysis** compares the **costs of alternative programs** with their effectiveness, usually measured in natural units suitable for the health outcome (e.g., lives saved, cases cured). - It does not assign a monetary value to the health outcome but rather identifies the intervention that achieves the **desired outcome at the lowest cost** or the maximum outcome for a given cost. *Management by objectives* - **Management by objectives (MBO)** is a strategic management model that aims to improve organizational performance by clearly defining objectives that are agreed to by both management and employees. - This concept is primarily about **setting goals and tracking performance** within an organization, not about analyzing program costs versus outcomes. *Cost utility study* - A **cost-utility analysis (CUA)** is a type of cost-effectiveness analysis where the health outcome is measured in **quality-adjusted life years (QALYs)** or disability-adjusted life years (DALYs). - It accounts for both the **quantity and quality of life**, but it still does not express benefits in direct monetary terms.

Q: What is the most cost-effective screening for identifying carcinoma cervix in a population?

High risk selective screening. ***Correct: High risk selective screening*** - **High-risk selective screening** is the **most cost-effective** strategy for cervical cancer screening as it targets populations with higher disease prevalence - Focuses resources on women at increased risk: age 30-65 years, multiple sexual partners, early sexual debut, HPV exposure, immunocompromised status, low socioeconomic status - **Maximizes detection yield per rupee spent** by concentrating efforts where disease probability is highest - Aligns with **WHO recommendations** and national guidelines for resource-limited settings - Better **cost-benefit ratio** compared to screening the entire population including low-risk groups *Incorrect: Mass screening* - Mass screening involves screening the **entire population** regardless of risk factors - While it may identify more total cases, it is **not cost-effective** as it expends resources on large low-risk populations - The question specifically asks for "**most cost-effective**" approach, not maximum coverage - In resource-limited settings (relevant for India), targeted screening provides better value *Incorrect: Multiphasic screening* - Refers to using **multiple screening tests** simultaneously for different diseases - Increases complexity and cost when applied to multiple conditions - Not specifically addressing cost-effectiveness for **single disease** (cervical cancer) screening *Incorrect: Prospective screening* - This term typically refers to **research methodology** involving forward-looking cohort studies - Not a standard classification of population screening strategies - More resource-intensive and used in research settings rather than routine public health programs

Q: Which one of the following is a quantitative method of health management?

Cost effectiveness analysis. ***Cost effectiveness analysis*** - This method uses **mathematical and statistical techniques** to compare the costs and health outcomes of different interventions, making it a quantitative approach. - It involves calculating metrics like the **incremental cost-effectiveness ratio (ICER)** to guide resource allocation decisions. *Communication management* - This involves strategies for **effective information exchange** within an organization and with external stakeholders, which is primarily a qualitative process. - While it can be measured (e.g., surveys), the core activity is not based on numerical data analysis for direct health outcomes. *Human Resource Management* - This focuses on managing an organization's **workforce**, including staffing, training, and performance evaluation. - It's mainly a qualitative and administrative function, although some aspects like budgeting for salaries might involve quantitative data. *Supportive supervision and leadership* - This involves **guiding and motivating staff** to achieve organizational goals and improve performance. - These are primarily **qualitative skills** and management styles, focusing on interpersonal interactions and team building.

Q: Which one among the following was used for measuring economic status of households, in the National Family Health Survey-III (NFHS-III) ?

Wealth index. ***Wealth index*** - The **National Family Health Survey-III (NFHS-III)** used a **wealth index** as a primary measure to assess the economic status of households. - This index is a composite measure derived from household assets and housing characteristics. *Lifestyle index* - The term "lifestyle index" is a general concept and was not the specific, officially recognized tool for measuring economic status in NFHS-III. - While lifestyle aspects can be indicators of economic status, they are typically integrated into broader indices like the wealth index rather than being a standalone measure in this context. *Pareek scale* - The **Pareek scale** was not used in NFHS-III for measuring household economic status. - The Pareek scale is a socio-economic status scale that primarily focuses on **occupational prestige** and education, and it is less commonly used for national health surveys in India compared to asset-based indices. *Kuppuswamy's scale* - **Kuppuswamy's Socioeconomic Status Scale** was not used in the NFHS-III survey. - This scale is an older and more commonly used tool in clinical and research settings within India, but it primarily classifies families based on **education** and **occupation** of the head of the family, and family income.

Q: The life expectancy at birth for a country A is 64 years. The minimum and maximum values of life expectancy are 20 years and 86 years respectively. As part of Human Development Index (HDI), what is the Life Expectancy Index for the country A ?

0.667. **0.667** - The Life Expectancy Index (LEI) is a component of the Human Development Index (HDI). - Formula: **LEI = (Actual Life Expectancy - Minimum Life Expectancy) / (Maximum Life Expectancy - Minimum Life Expectancy)** - Calculation: (64 - 20) / (86 - 20) = 44 / 66 = **0.667** - The index ranges from 0 to 1, where higher values indicate better life expectancy relative to the reference range. *0.512* - This value would result from calculation errors, such as using incorrect minimum or maximum values. - For example, if a different denominator was used or if the actual life expectancy was miscalculated. *0.970* - This value is too high and suggests a calculation error. - An index of 0.970 would indicate the country's life expectancy is 84 years (very close to the maximum of 86 years). *0.744* - This value does not correspond to the given parameters. - Could result from arithmetic errors or using different reference values for minimum/maximum life expectancy. - Using the correct formula with given values yields 0.667, not 0.744.

Q: Identify the index?

Human developmental index. ***Human developmental index*** - The **Human Development Index (HDI)** is the correct answer as the diagram exactly represents its three core dimensions - HDI measures overall achievement in: **Health** (life expectancy at birth), **Education** (mean years of schooling and expected years of schooling), and **Living standards** (GNI per capita) - These are the standard components published by UNDP for calculating HDI - HDI is a summary measure of average achievement in key dimensions of human development *Human poverty index* - The Human Poverty Index (HPI) was an older measure that has been discontinued - HPI focused on deprivations rather than overall development achievements - The diagram shows development indicators (positive achievements), not deprivation indicators - HPI has been replaced by the Multidimensional Poverty Index (MPI) *POLI* - **POLI** (Physical Quality of Life Index) is a different index that uses infant mortality, life expectancy at age one, and literacy rate - The components shown in the diagram (mean years of schooling, expected years of schooling, GNI per capita) are not part of POLI - This is not a recognized standard index in current use *Multidimensional poverty index* - The **Multidimensional Poverty Index (MPI)** measures acute multidimensional poverty across health, education, and living standards - However, MPI uses **different specific indicators**: nutrition, child mortality, years of schooling, school attendance, cooking fuel, sanitation, drinking water, electricity, housing, and assets - The diagram shows HDI components (life expectancy, mean/expected years of schooling, GNI per capita), which are NOT the MPI indicators - MPI focuses on deprivations at the household level, while the diagram shows aggregate development measures

Q: Which of the following evaluation methods primarily involves monetary terms?

Cost benefit analysis. ***Cost benefit analysis*** - This method evaluates both the **costs** and **benefits** of a project or intervention in **monetary terms**. - It is the **only economic evaluation method** that expresses **both costs AND outcomes (benefits) in monetary units**. - This allows for a direct comparison of the financial value of benefits against the financial value of costs to determine overall worth and calculate net benefit or benefit-cost ratio. *Network analysis* - **Network analysis** is a quantitative method that focuses on relationships or connections between entities. - It is primarily used for understanding **structures and patterns** in complex systems (like disease transmission networks), not for direct monetary valuation. - This is **not an economic evaluation method**. *Cost minimization analysis* - This method compares only the **costs** of two or more interventions that are proven to have **equivalent outcomes or effectiveness**. - While it deals with costs in monetary terms, it **does not express benefits/outcomes in monetary units** - it simply assumes they are equal. - The primary goal is to identify the **least expensive option** among equally effective alternatives, not to monetize outcomes.

Q: In ESI, employee contributes what percentage of wages?

1.75%. ***1.75%*** - Under the **Employees' State Insurance (ESI) scheme**, the employee's contribution rate was **1.75% of their monthly wages** (prior to 2019 amendment) [1]. - However, note that **as per the latest amendments (effective July 2019)**, the employee contribution has been **reduced to 0.75%** and employer contribution to 3.25%. - This question tests knowledge of the **historically significant rate** of 1.75% which was in effect for many years and is still commonly referenced in medical PG examinations. *4.75%* - This percentage is **incorrect** for the employee's contribution rate to ESI. - This was the **employer's contribution rate** under the older scheme structure [1]. *3.75%* - This figure is **not a standard ESI employee contribution rate**. - This may represent a **proposed or transitional rate** but was not a long-standing official rate. *2.75%* - This rate is **neither the current nor historical employee contribution rate** for the ESI scheme. - This does not correspond to any **standard ESI contribution structure**.

Question 1

In a programme, analysis of results in comparison to cost is known as

Accepted Answer

Cost benefit analysis

Answer

Cost effective analysis

Answer

Management by objectives

Answer

Cost utility study

Question 2

What is the most cost-effective screening for identifying carcinoma cervix in a population?

Accepted Answer

High risk selective screening

Answer

Prospective screening

Answer

Mass screening

Answer

Multiphasic screening

Question 3

Which one of the following is a quantitative method of health management?

Accepted Answer

Cost effectiveness analysis

Answer

Communication management

Answer

Human Resource Management

Answer

Supportive supervision and leadership

Question 4

Which one among the following was used for measuring economic status of households, in the National Family Health Survey-III (NFHS-III) ?

Accepted Answer

Wealth index

Answer

Lifestyle index

Answer

Pareek scale

Answer

Kuppuswamy’s scale

Question 5

The life expectancy at birth for a country A is 64 years. The minimum and maximum values of life expectancy are 20 years and 86 years respectively. As part of Human Development Index (HDI), what is the Life Expectancy Index for the country A ?

Accepted Answer

0.667

Answer

0.512

Answer

0.970

Answer

0.744

Question 6

Identify the index?

Accepted Answer

Human developmental index

Answer

POLI

Answer

Human poverty index

Answer

Multidimensional poverty index

Question 7

Which intervention has shown the highest return on investment in national STI control programs?

Accepted Answer

Integration with HIV services

Answer

Mobile testing units

Answer

Online partner notification

Answer

Mass media campaigns

Question 8

Which of the following evaluation methods primarily involves monetary terms?

Accepted Answer

Cost benefit analysis

Answer

Network analysis

Answer

Cost minimization analysis

Answer

All of the options

Question 9

In ESI, employee contributes what percentage of wages?

Accepted Answer

1.75%

Answer

4.75%

Answer

3.75%

Answer

2.75%

Question 10

Which of the following best describes economic blindness?

Accepted Answer

A level of blindness that prevents an individual from earning a livelihood.

Answer

Blindness that is expensive to treat.

Answer

Blindness affecting only economically disadvantaged populations.

Answer

Blindness due to economic factors like malnutrition.

Health Economics — MCQs

Health Economics — MCQs

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