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

Bioethics 24 (9):470-480 (2009)
  Copy   BIBTEX


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.



    Upload a copy of this work     Papers currently archived: 92,100

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles


Added to PP

88 (#193,550)

6 months
6 (#526,006)

Historical graph of downloads
How can I increase my downloads?

Citations of this work

Challenges for Principles of Need in Health Care.Niklas Juth - 2015 - Health Care Analysis 23 (1):73-87.
Indeterminacy and the principle of need.Herlitz Anders - 2017 - Theoretical Medicine and Bioethics 38 (1):1-14.
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.

View all 14 citations / Add more citations

References found in this work

The Value of Life.John Harris - 1985 - Mind 95 (380):533-535.
Needs and Global Justice.Gillian Brock - 2005 - Royal Institute of Philosophy Supplement 57:51-72.
Fundamental Needs.Garrett Thomson - 2005 - Royal Institute of Philosophy Supplement 57:175-186.

View all 8 references / Add more references