Session 8 - Resource allocation Flashcards
1
Q
Why is rationing important in healthcare?
A
- Demand >supply = scare resources
- Priorities need to be set out in order to effectively utilise resources as cannot fund every new tx
- Ageing population means an increase in long term conditions
2
Q
What role does NICE play in resource allocation?
A
- Enables evidence of clinical and cost effectiveness to be integrated to inform a national judgement on the value of a treatment relative to alternative uses of resources
- Provides guidance on reccommended treatment
- Increases equity
- Approved Txs by NICE must be funded by local NHS trust
3
Q
Describe the ethics of resource allocation
A
-Goal of a resource needs to be clear and explicit with who benefits from the public expenditure
4
Q
What is explicit rationing?
A
- Rationing which is based on defined rules of entitlement
- uses institutional procedures for systematic allocation of resources with technical processes to assess efficiency and equity
- Care is limited and decisions/reasoning are explicit
5
Q
What are the advantages of explicit rationing?
A
- Transparant and accoutable
- Oppotunity for debate
- Clearly evidence based
- Equity in decision making
6
Q
What are the disadvantages of explicit rationing?
A
- Very complex
- does not take into account heterogeneity of patients and illness
- Potential to creat patient and professional hostility
- Impacts on clinical freedom
7
Q
What is implicit rationing?
A
- Care is limited but decisions/reasoning is not clearly expressed
- Allocation of resources is by clinical decisions without explicit criteria as clinicians make decisions based on overall budgetary constraints
8
Q
What are the advantages of implicit rationing?
A
- Takes into account heterogeneity of disease
- Patients believe decisions made on clinical need not money
9
Q
What are the disadvantages of implicit rationing?
A
- Open to abuse
- Inequity and discrimination
- Based on ‘social deservingness’
