Flashcards in Session 8 - Resource allocation Deck (9)
Why is rationing important in healthcare?
-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
What role does NICE play in resource allocation?
-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
-Approved Txs by NICE must be funded by local NHS trust
Describe the ethics of resource allocation
-Goal of a resource needs to be clear and explicit with who benefits from the public expenditure
What is explicit rationing?
-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
What are the advantages of explicit rationing?
-Transparant and accoutable
-Oppotunity for debate
-Clearly evidence based
-Equity in decision making
What are the disadvantages of explicit rationing?
-does not take into account heterogeneity of patients and illness
-Potential to creat patient and professional hostility
-Impacts on clinical freedom
What is implicit rationing?
-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
What are the advantages of implicit rationing?
-Takes into account heterogeneity of disease
-Patients believe decisions made on clinical need not money