Health Economics and Qualitative Methods
Costs, economic evaluation, QALY and DALY, opportunity cost and discounting, plus qualitative designs, sampling, data collection, rigour and analysis.
How to prepare for MRCPsych Paper B
Integrate clinical formulation, safety and current UK practice with disciplined appraisal of design, bias, estimates and applicability.
Core concepts
Concept 1
Economic evaluation compares costs and consequences: cost-effectiveness uses a natural outcome, cost-utility commonly uses QALYs, and cost-benefit values both in monetary terms.
Exam cue: State the perspective, time horizon, comparator, costs, outcome unit, discounting and uncertainty for an economic result.
Concept 2
Qualitative research explores meaning and experience through approaches such as grounded theory, phenomenology and ethnography, using reflexive sampling, data collection and interpretation.
Exam cue: Judge qualitative rigour through fit of method, sampling, depth, reflexivity, analytic transparency and support from the data.
Risk pitfalls and guardrails
Calling the cheapest intervention cost-effective without comparing incremental outcome.
Guardrail: Do not equate statistical significance with importance or a non-significant result with proof of no effect.
Applying statistical representativeness criteria unchanged to purposive qualitative sampling.
Guardrail: Do not choose an option because it is merely familiar or associated; show why it best answers this lead-in.
Memory anchors
What is opportunity cost?
The benefit forgone from the best alternative use of the same resources.
What is a QALY?
A year of life weighted by health-related quality, used to combine length and quality of life.
What is an incremental cost-effectiveness ratio?
The difference in cost divided by the difference in effect between alternatives.
What is reflexivity?
The researcher's explicit examination of how position, assumptions and interaction shape data and interpretation.
What is data saturation?
The point at which further data collection is no longer adding material insight to the developing analysis, interpreted within the method.
Checkpoint rule
Do the check-up only after you can summarize each concept in one sentence and identify one dangerous pitfall from memory.
Knowledge Check (after reading)
Short check-up to confirm understanding of this module.
Check-up Questions
A service chooses one programme, meaning another beneficial programme cannot be funded. What is the forgone benefit called?
An evaluation compares two therapies by cost per additional depression-free day. What type is this?
Answer all questions to submit.
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Move forward only after this module is stable.
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