Rationing healthcare in New Zealand: the use of clinical guidelines.
A 1991 "Green and White Paper", Your health and the public health. A statement of government health policy, advised that healthcare services in New Zealand could be rationed by a simple list. The Health and Disability Services Act 1993 provided a framework for resource allocation. The Core Services Committee rejected the "Oregon approach" of using a simple list to determine what condition/treatment pairs should be funded, preferring the development of clinical guidelines as a basis for assessment. Clinical priority assessment criteria derived from guidelines are used to define the degree of clinical benefit for public funding. Criteria have been developed for entry into end-stage renal failure programs, access to coronary artery surgery, and entry into booking systems for other elective services. The development of clinical criteria to define access to services has had a difficult road, but is a start in defining public expectations of New Zealand's healthcare system.
Feek
C M
CM
Ministry of Health, Wellington, New Zealand. colin_feek@moh.govt.nz
D001071:Appointments and Schedules; D002387:Cataract Extraction; D001026:Coronary Artery Bypass; D004608:Eligibility Determination / Q000379:methods*; D017048:Health Care Costs; D015276:Health Care Rationing / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards*; D006292:Health Priorities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis; D013222:State Medicine / Q000191:economics*