Allocating resources: community involvement is not easy.
Resources for health care are limited in all societies; decisions have to be made about who gets what health care. A case study is discussed. Jaymee Bowen was a British child whose Health Authority refused to provide free treatment for her advanced leukaemia. The media advertised her case and public opinion was mobilized in favour of treating her with public funds. Cost-effectiveness can be used to identify treatments that provide value-for-money. The public can express an opinion on what kinds of care are wanted--for example, what are the relative benefits of preventing morbidity or mortality, or of helping children rather than young people? Rational criteria can be developed with public involvement--in the case of Jaymee Bowen, the proposed treatment really did not appear to offer value-for money. But some individual cases that contradict the 'rational' criteria for the population as a whole will always be able to attract public sympathy and interest.
Richardson
R
R
Institute for Health Sector Development, London, UK.
Waddington
C
C
D016026:Bone Marrow Transplantation / Q000191:economics; D002648:Child; D018672:Community Health Planning; D003256:Community Participation; D003659:Decision Making, Organizational; D005260:Female; D015276:Health Care Rationing / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards*; D006801:Humans; D008402:Mass Media; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery; D011639:Public Opinion; D013222:State Medicine / Q000191:economics; D006113:United Kingdom; D026712:Value of Life