Overview[ edit ] Economic systems is the category in the Journal of Economic Literature classification codes that includes the study of such systems.
Hendrick, Churchill Livingstone Chapter 13 table Resource allocation in modern society objections have been made against QALYs. Many healthcare interventions are not the subject of a QALY assessment and Resource allocation in modern society comparisons between the cost -effectiveness of different treatments is not possible.
QALYs are based on population-level information. They do not take into account the personal response of individuals to their illness and their views of their need for treatment.
Ageism is unfair discrimination against a person on the grounds of their age. Individuals who have a greater span of life ahead of them, typically a younger person, would gain more from treatment on the basis of their predicted life expectancy in comparison with an older person who would have fewer years to benefit from a particular healthcare treatment.
So a one -off life-saving intervention performed on a one-year old with a life expectancy of 80 years has a better QALY rating than the same intervention performed on a 70 year old. This would not apply to all treatments. If the treatment needs to be continued indefinitely then the cost per QALY calculation may not favour the younger person because the cost would be greater the longer the patient continued to live.
There are conflicting views about whether QALY calculations are ageist. An urgent life-saving treatment for an 80 year old, who was then expected to live 5 years would have the same priority, under the QALY method, as a 40 year old whose life-expectancy was 5 years because of some underlying, untreatable illness.
Cambridge University Press Those who have a disability would be considered to have a lower quality of life and therefore would benefit less from treatment for an independent separate condition than those who, with treatment could be returned to full health.
Journal of Medical Ethics A PCT has to decide on whether to allocate resources to neonatal intensive care services or to increase provision of coronary artery bypass grafts. A QALY assessment will look at the relative cost of the different treatments and the change in quality of life and life expectancy that will result if the treatment is provided.
Neonatal intensive care and coronary artery bypass grafts will both save lives. Some patients who require neonatal intensive care will go on to have healthy lives QALY value of 1 for each year of life while others may have diminished quality of life.
Patients having coronary artery bypass grafts may not be completely healthy following treatment and will therefore not achieve a QALY value of 1 for each year of life.
As heart disease is more common in the elderly, the average life expectancy for patients having coronary artery bypass grafts is likely to be less than that for patients requiring neonatal intensive care.
Assuming for the sake of this example that the cost of neonatal intensive care and the cost of coronary artery bypass grafts are the same, then even though some babies will not survive intensive care, the potential life expectancy of the survivors will tend to weigh in favour of this intervention, and against the intervention that is aimed at an older age group.
Equity and Distributive Justice A possible criticism of the utilitarian or QALY based approach to resource allocation is that it does not provide an equitable or fair way of distributing resources.
Aristotle, explaining his view of distributive justice, says, in effect, that equals should be treated equally, and unequals treated unequally in proportion to the relevant inequalities. Its value lies in its implicit demand that we spell out the criteria we are using when we call people equal or unequal.
The utilitarian or QALY based approach could be said to treat unequals equally, in that it does not take account of differences in need for health care but focuses entirely on the benefit gained from an intervention. Some individuals or groups of patients will have poorer health than others, or more serious diseases, and will have a greater need of health care.
If degree of need is a main criterion, a just distribution of health care resources may require that these individuals or groups have more resources, even if the benefit gained by treatment is small compared to that achieved by a different treatment in patients who are less sick.
Norman Daniels has applied this theory to the context of health care. Thus, in the context of health care we should allocate resources to ensure that those in poorest health, or greatest need, are as well off, in terms of health, as they can be.
Assessing and addressing inequity Reducing health inequalities is seen as an important aim of the National Health Service. But there are different ways of looking at inequality, and some inequalities may be easier to address than others. Which inequalities are inequitable, that is, unfair?
Other types of inequality arise when comparing access to treatments for different conditions. How does one compare the need for hip replacement with the need for smoking cessation clinics, or the need for a new cancer therapy with the need for a treatment for multiple sclerosis?
Even within the context of a specific medical condition, some patients may have a greater need for treatment because of more severe disease.
Thus providing equal treatment without some assessment of health status or healthcare need is not always a just or equitable approach in health care. Considering the social determinants of health Non-medical factors may produce inequalities between individuals or groups with the same medical conditions such that more resources are required to achieve the same benefit in health.
For example, greater resources per person may be needed to improve mortality and morbidity from diabetes or ischaemic heart disease in groups with a high degree of social deprivation than in affluent middle class patients.
Is it equitable fair to provide greater resources for the more disadvantaged group. Faced with a range of possible societies or possible methods of healthcare resource allocation you must decide which society you would wish to live in given that you would not know your position in that society, whether you would be old or young, rich or poor sick or healthy.
Rawls would argue that a rational person would choose the society or to allocate resources so that the most disadvantaged were as well off as they could be. Determining morally relevant reasons for treating people differently In considering equitable distribution of health care resources, care must be taken to ensure that any differences between individuals or groups that are used to justify different treatment are morally relevant differences.
Thus, differences in race, sex or income are not seen as morally relevant. More controversial issues include whether factors such as personal responsibility for health and the presence of dependents are morally relevant in decisions about priority - setting in health care.Resource allocation is a process and strategy involving a company deciding where scarce resources should be used in the production of goods or services.
A resource can be considered any factor of. The process of consumer resource allocation, which precedes choice behavior, is a relatively unexamined phenomenon.
The contributions and the deficiencies of available resource allocation models are reviewed. The process of consumer resource allocation, which precedes choice behavior, is a relatively unexamined phenomenon. The contributions and the deficiencies . considers resource allocation in a society characterised by a preference for the private-sector approach.
extremes seems feasible for governments in modern society. There is a continuous logical departure point for the analysis of the role and functions of government.
Due. It looks like you've lost connection to our server. Please check your internet connection or reload this page. Allocation of resources is a central theme in economics (which is essentially a study of how resources are allocated) and is associated with economic efficiency and maximization of utility.