Help or hindrance? The role of economics in rationing health care.
The economic evaluation of alternative diagnostic and therapeutic interventions is not merely a help to the processes by which decision makers allocate scarce economic resources, it is an essential ingredient into those rationing processes. Clinicians and other decision makers who advocate the use of effectiveness data alone to determine who will be treated and who will be left in pain and discomfort may perpetuate the inefficient use of resources. Rationing, or resource allocation, in health care must be informed by knowledge of the costs and consequences (effects) or alternative interventions. To ignore the economic element in clinical choices, generates inefficiency, and therefore unethical practice. The great advantage of the economic approach to rationing is that it requires an explicit framework which identifies the costs and benefits of alternative actions in all domains of human action. The combination of explicitness and precision inherent in good economic evaluation can only help in the difficult task of producing further health benefits for patients from the limited resources of the NHS.
Maynard
A
A
Centre for Health Economics, University of York, UK.
Bloor
K
K
D015276:Health Care Rationing / Q000191:economics*; D005102:Health Expenditures; D006296:Health Services / Q000600:supply & distribution; D006801:Humans; D009426:Netherlands; D009520:New Zealand; D009922:Oregon; D013222:State Medicine / Q000191:economics*; D006113:United Kingdom