Quiz 10: Finance and procurement

Please choose the one, most correct answer to each question or statement.

In healthcare, “out of pocket” expenditure refers to:
- Money that is usually paid up front and later claimed back from a medical aid
- Money that is usually paid up front and later paid back from an insurance company
- Money that is paid for healthcare and not paid back
- Healthcare that is free
Which of these is an example of “out of pocket payments” to purchase healthcare?
- In many low income countries, there are community insurance schemes where households pay into a common pool
- Monthly payments into a medical scheme in South Africa
- Purchase of spectacles by a person without medical cover
- Clinic visits for childhood immunisation by a family without medical insurance
Which of these statements about medical schemes in South Africa is true?
- A medical scheme can increase an individual’s monthly payments if the individual has a history of expensive claims
- They generally pay out a cash lump sum in the event of injury or illness
- They are profit making companies
- They are regulated by the Council for Medical Schemes
Which of these is a multilateral aid organisation?
- The Gates Foundation
- Britain’s Department For International Development (DFID)
- US Aid for International Development (USAID)
- The World Health Organisation
In South Africa:
- Around 80% of healthcare funding comes from government expenditure
- Around 80% of healthcare funding comes from private expenditure
- Around 50% of healthcare funding comes from international funds
- Around half of healthcare spending is government expenditure and half private expenditure
Why are private financing initiatives often very costly for the public sector?
- They are not very costly as private financing initiatives are usually very beneficial to both parties
- The public sector often lacks the skills to negotiate contracts that are beneficial in the long term
- The state retains control of its assets and therefore has to maintain them
- Private companies lease the use of facilities to the government at low cost
Which of these could be considered a “private financing initiative”?
- A private company builds and maintains a group of clinics that are leased back to the government
- Government and private ambulances agree to use a common call out system and the nearest vehicle will respond. Private ambulances responding to patients without a medical aid will be paid a service fee by the government.
- A government hospital does not offer a radiology service after 4pm. It is agreed that the local veterinary hospital can use the scanner after hours for a rental fee.
- People decide to pay a private doctor so they can have a referral to a specialist clinic and bypass the outpatient clinic.
Which of these could be considered “contracting out”?
- A private company builds and maintains a group of clinics that are leased back to the government
- Government and private ambulances agree to use a common call out system and the nearest vehicle will respond. Private ambulances responding to patients without a medical aid will be paid a service fee by the government.
- A government hospital does not offer a radiology service after 4pm. It is agreed that the local veterinary hospital can use the scanner after hours for a rental fee.
- People decide to pay a private doctor so they can have a referral to a specialist clinic and bypass the outpatient clinic.
Of the several types of public-private partnerships, which can be considered co-use of state assets?
- A private company builds and maintains a group of clinics that are leased back to the government
- Government and private ambulances agree to use a common call out system and a private ambulances responding to patients without a medical aid will be paid a service fee by the government.
- A government hospital does not offer a radiology service after 4pm, so it is agreed that the local veterinary hospital can use the scanner after hours for a rental fee.
- People decide to pay a private doctor so they can have a referral to a specialist clinic and bypass the outpatient clinic.
Which of the following people would be required to pay user fees in a South African government facility?
- A 2-year-old infant with croup
- A pregnant woman who has a family income of R250 000 per year
- A drug addict on a disability grant who has a broken leg
- A senior doctor who is knocked down by a car in the hospital car park
What is the purpose of a tender?
- To make sure that the cheapest possible option is purchased
- To grow relationships between the public and private sector
- To obtain goods and services of acceptable quality at the best price
- To use the same suppliers
What does inventory management mean?
- The use of forms and records to track the flow of drugs and supplies through the distribution system
- The management of novel approaches to treatment
- Monitoring the appropriate use of antibiotics
- Managing the ordering of drugs and supplies
Which statement about inventory management is true?
- It is important in larger facilities but clinics can use informal record keeping
- Only pharmacists and senior managers should be responsible for inventory management
- Inventory management in South Africa is generally good
- Inventory management is critical in all facilities to prevent stock outs and wastage. It often has to be done by clinical staff, who should be properly trained.
What is the advantage of bulk ordering by the National Department of Health?
- Drugs can be purchased more cheaply
- It is quicker
- There is less theft
- The quality of the supplies is lower
In South Africa:
- The National Department of Health decides the type and quantity of drugs required by each facility
- The Provincial Departments of Health decides the type and quantity of drugs required by each facility and distributes this as a “kit”
- The Central Procurement Agency is responsible for deciding the types and quantities of drugs for each type of facility
- Facilities place orders at the provincial depot based on the previous year’s consumption
In South Africa, the most common cause of stock outs is probably:
- Drugs have not cleared customs and are sitting at the port
- Poor inventory management in facilities and at provincial depots
- The Central Procurement Agency has not paid suppliers
- Global shortages of drugs
A doctor working in a government facility orders a new, very effective antibiotic for a patient with pneumonia but the pharmacy card returns with “out of stock” written on it. What is the most likely cause?
- The antibiotic is not on the Essential Medicines List and has not been procured for state use.
- Poor inventory management at the provincial depot
- Global shortages of the drug
- Suppliers have not been paid
What does an “overstock” mean?
- These are items that are used a lot and therefore need to be ordered in larger quantities
- Too much has been ordered, so the item may expire and be wasted
- These are items that are “over and above” the items on the Essential Medicines list
- Too much has been ordered, but this is not important as it is better to be safe than sorry
What is “minimum stock”?
- The level of stock that should trigger a re-order so that new supplies can arrive before it runs out
- Personal protective items such as gloves
- The items that should always be on hand, such as adrenalin
- The items that are rarely used and therefore never in short supply
What is a good way for clinical staff to avoid over stocks and stock outs of “ward stock”?
- Decide on maximum and minimum stock levels with the help of a pharmacist and to place cards indicating these levels in the compartment, shelf or drawer.
- The person who uses the last item is responsible for ordering more from the pharmacy
- Keep plenty of “back up” stock in the store cupboard
- Produce a pamphlet about the procurement and ordering process to give to new staff and students