Description
This academic presentation delves into the critical and complex issues of priority setting, resource allocation, and rationing within healthcare systems. It examines the fundamental questions faced by policymakers and clinicians when assigning limited resources, such as which services to fund and which patient populations to prioritize. The material introduces a structured framework based on four core values: promoting equality, helping the worst-off, maximizing benefits, and promoting social usefulness. Each value is explored through practical principles like using lotteries, prioritizing the sickest or youngest, saving the most lives, and considering prognosis or instrumental value, illustrated with a compelling case study on allocating a single liver transplant among three candidates of different ages. This resource is invaluable for tertiary-level students and professionals in public health, health policy, medicine, and bioethics, providing the ethical tools and theoretical grounding needed to navigate real-world dilemmas of scarcity and fairness in health resource distribution. Download this presentation to enhance your understanding of ethical decision-making in healthcare management and policy.
What's inside
Priority Setting and Rationing of Health Resources Chris Mweemba Conceptual Distinctions 1. Priority Setting 2. Resource Allocation 3. Rationing Allocating Health Care Resources • Resource allocation is used to assign the available resources within the health care sector • The choice of which service to prioritize • What level of resources a service should receive? • Which services should go unfunded? • Which items should be sacrificed if total funding is reduced? Needs-based formulae • Population size • Demographic composition • Burden of ill-health • Socio-economic status • Private sector use / insurance coverage • Population density or other factors that affect cost of providing health care Case example: Who Should Get the Liver? • A tragedy has struck. A 30 year old woman has died in a car accident. Then a wonderful thing happens, her husband has decided to donate her organs for transplantation.. • The problem is, there are 3 transplant patients waiting for her liver Case example adopted from Emmanuel Ezekiel’s Lecture at University of Pennsylvania Case example: Who Should Get the Liver? Patient #1 is Joey • 2 years old • Mother is a school teacher, father is a civil servant • Starting to speak in 2-3 word sentences Case example: Who Should Get the Liver? Patient #2 is Melissa • 22 years old • Just graduated from college with a bachelor’s degree • Wants to get a postgraduate degree and go into public health or mental health counseling Case example: Who Should Get the Liver? Patient #3 is Charles • 70 years old • Recently retired after working for nearly 50 years • Has 6 grandchildren Case example: Who Should Get the Liver? A. Joey B. Melissa C. Charles • Why? The question? • How do we allocate the limited resources we have under conditions of scarcity? Theories for Resource Allocation • Four (4) Values come into play • Promote Equality – Kantian value • Help the worse off - Rawlsian value • Maximize benefits – Utilitarian value • Promote and reward social usefulness The Four (4) Values • Promote Equality • Equality of opportunity and not equality of resources • Help the worse off • Extra benefits for the worse off • Who is worse off? • Maximize Benefits • Different vies of what constitutes a benefit • Promote and Reward Social Usefulness • Different view of what is socially useful
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