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Nursing Assignment Sample on Economics in health

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Nursing Assignment Question

Write a Case Study on the Topic:

Topic: The Australian Healthcare system is founded on the concept of equity of access. Discuss this statement with relation to the concept of effectiveness and efficiency and any interrelationships that may exist.

Nursing Assignment Solution on Economics in health


According to an article by Plos Medicine (Irwin A, 2006), despite the unequalled amount of global assets and technological advancements in today's world, health inequity is increasing, making the poor section of society more underprivileged (lack of access to health services, low life expectancy rates, high mortality rates and so on).

Arah says in his paper (Arah, Klazinga, Delnoij, Asbroek, & Custers, 2003) that Australia has a distinguished and invariable national health care regime which is maintained jointly by the governments at the national and state level. Its health performance framework based on the determinants of health has three tiers. They are as follows:

  • 'Health status and outcomes': includes dimensions like state of health, human functions, expected years to be lived, well-being and mortality rates.
  • 'Determinants of health': includes factors related to the society, economy, environment, community, health and the individuals.
  • 'Health system performance': includes dimensions like effectiveness, efficiency, safety and so on…

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'Equity is defined as the ability to impartially recognize the right of every person, a sense of justice and impartiality being its guiding principles. Access is the establishment of communication to obtain information or use of available resources. Therefore, from the social perspective, equity of access means equal rights to information and available resources.' (Araújo, Caporale, Stefani, Pinto, & Caso, 2011).

Health equity and other factors that affect public health, have gained immense importance in the agendas of national and international entities. The increasing need for data on health inequities and resource allocation has also been recognized recently (Welch, Petticrew, Tugwell, Moher, O'Neill, & (2012), 2012).

There have been ever-increasing debates among organizations and academicians concerning the various definitions of 'equity'. Braveman and Gruskin, in their paper (Braveman & Gruskin, 2003), give the definition of equity as the lack of methodical inconsistencies within healthcare, between richer and poorer sections of society. They define equity from the perspective of social justice and equal human rights. They've also criticized usage of the word 'avoidable' in the definition of equity in health in the 1990's 'Concepts and Principles' paper for two reasons…

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Efficiency makes sure, that the resources used in health care, are utilized to its maximum limit (with minimal wastage) or not. It relates resource inputs (various costs pertaining to the healthcare process) to the outcomes (the number of patients treated, etc.) or the outcomes (health gain in the form of increased life expectancy and so on). Inefficiency is said to exist, when resources are not allocated properly to be able to extract the last unit of value from it and could still be reallocated to increase the health gains produced (Palmer & Torgerson, 1999) 


This paper (Arah, Klazinga, Delnoij, Asbroek, & Custers, 2003) conceives 'effectiveness' as a performance aspect of a health system, where a policy change, intervention or healthcare action achieves the coveted outcomes within a stipulated time-period. The Australian framework clearly includes the time factor to make sure whether the specific goals are achieved within the proper time-period or not. Arah states that 'effectiveness' indicators are usually taken from the early detection and prevention factors in population health (including education on HIV, safe sex practice, breast checkups, diagnosis of minor cancers). They can also be called output, outcome or process indicators. The 'effectiveness' dimension includes the dominions of quality, appropriateness, access and time, in its operation. According to the US framework (given by The Institute of Medicine), 'effectiveness' is defined as dispensing services with scientific understanding, to all those who could benefit from it and avoid any overuse or underuse of it…

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Two important policy objectives in resource allocation are equity and efficiency. The school of health economics, conventionally, has given more priority to the maximization of efficiency, but, it has also addressed inequities in health. However, economic calculations have a greater focus on efficiency maximization with comparatively less importance to the distribution of these benefits among all sections of society. In reality, maximization of efficiency alone does not lead to health equity, and in some cases, might end up worsening situations. Hence, economic approaches in healthcare decisions tend to be more limited than in other cases (Ong, Kelaher, Anderson, & Carter, 2009).

Hence starts the ceaseless debates concerning equity and efficiency in healthcare. It is crucially declared that, as health equity increases, lesser will be levels of efficiency. This clash is persistent in economics related theory of market efficiency. The paper (Reidpath, Olafsdottir, Pokhrel, & Allotey, 2012) phrases an important question, 'which is more important for the population of society; an equitable health system with fair distribution, or a system which maximizes health gains?' …

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With equity as the encompassing factor, these two play a major role in determining the health-system performance. Even though there might be illusions about possible trade-offs between them, they are quite complementary to each other. While efficiency compares the amount of inputs/resources used to the outcomes achieved, effectiveness holds a greater meaning in the healthcare system by weighing the effects of the inputs/policies on health gain (planned outcome). Efficiency ensures that resources are not wasted, maximizes use of fixed inputs while reducing cost…


Modern health policies must make sure that underprivileged sections of society receive equal benefits of the developments on the healthcare system (Tugwell, Savigny, Hawker, & Robinson, 2006). Tugwell emphasizes on the relation between equity and effectiveness. He provides a measure for calculating the ratio between equity and effectiveness ratio. This examines the effect of certain factors, on the difference in the effectiveness of intervention policies in various sections of society…

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Australia is in a good position, having formulated health-sector reforms, to prevent avoidable diseases and promoting good health with its high level of clinical care, training and so on. But, the division between state and Commonwealth funded health services is compromising on patient health and creating major confusion, wastage and duplication (Jackson, Nicholson, & McAteer, 2010). Jackson et al say that a proper regional governance structure is required for stating the intersectional responsibilities distinctly, merging activities and improving the efficiency and quality of healthcare across Australia's health sectors.

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