An inquiry into the principles of needs-based allocation of health care

Bioethics 24 (9):470-480 (2010)
Abstract
The concept of need is often proposed as providing an additional or alternative criterion to cost-effectiveness in making allocation decisions in health care. If it is to be of practical value it must be sufficiently precisely characterized to be useful to decision makers. This will require both an account of how degree of need for an intervention is to be determined and a prioritization rule that clarifies how degree of need and the cost of the intervention interact in determining the relative priority of the intervention. Three common features of health care interventions must be accommodated in a comprehensive theory of need: the probabilistic nature of prognosis (with and without the intervention); the time course of effects; and the fact that the most effective treatments often combine more than one intervention. These common features are problematic for the concept of need. We outline various approaches to prioritization on the basis of need and argue that some approaches are more promising than others.
Keywords rule of rescue  non‐welfarist approaches  healthcare need  cost‐effectiveness  resource allocation  distributive justice
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DOI 10.1111/j.1467-8519.2009.01734.x
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Challenges for Principles of Need in Health Care.Niklas Juth - 2015 - Health Care Analysis 23 (1):73-87.
From Needs to Health Care Needs.Erik Gustavsson - 2013 - Health Care Analysis (1):1-14.
Health-Care Needs and Shared Decision-Making in Priority-Setting.Erik Gustavsson & Lars Sandman - 2015 - Medicine, Health Care and Philosophy 18 (1):13-22.

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