title: Key factors that influence government policies and decision making about healthcare priorities: Lessons for the field of eating disorders.
abstract: Worldwide, the demand for healthcare exceeds what individuals and governments are able to afford. Priority setting is therefore inevitable, and mental health services have often been given low priority in the decision-making process. Drawing on established economic criteria, and specifically the work of Philip Musgrove, key factors which influence government decision-making about health priorities are reviewed. These factors include the size of the health burden, the availability of cost-effective interventions to reduce the burden, whether private markets can provide the necessary treatment efficiently, whether there are "catastrophic costs" incurred in accessing treatment, whether negative externalities arise from not providing care, and if the "rule of rescue" applies. Beyond setting priorities for resource allocation, governments also become involved where there is a need for regulation to maintain quality in the delivery of healthcare. By providing field-specific examples for each factor, we illustrate how advocates in the eating disorder field may use evidence to inform government policy about resource allocation and regulation in support of individuals with an eating disorder.
authors.affiliation: School of Public Health, University of Queensland, Queensland, Australia.|Institute of Health Metrics and Evaluation, University of Washington, Seattle, Washington.
authors.forename: Harvey
authors.initials: H
authors.lastname: Whiteford
authors.affiliation: Department of Psychology, Wesleyan University, Middletown, Connecticut.
authors.forename: Ruth Striegel
authors.identifier: 0000-0001-6121-4641
authors.initials: RS
authors.lastname: Weissman
mesh_terms: D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D001068:Feeding and Eating Disorders / Q000191:economics / Q000628:therapy*; D006076:Government; D006078:Government Programs / Q000191:economics / Q000331:legislation & jurisprudence; D006292:Health Priorities; D006297:Health Services Accessibility / Q000191:economics / Q000331:legislation & jurisprudence; D054625:Healthcare Disparities / Q000191:economics / Q000331:legislation & jurisprudence; D006801:Humans; D017149:Private Sector
keywords: advocacy; cost of illness; cost-effectiveness; eating disorder; public policy