MyAssignmentServices uses cookies to deliver the best experience possible. Read more

Resource Allocation and Priority Setting

1. Need for Priority Setting in Healthcare

Priority setting is used for providing a comprehensive range of important services that are aligned with the social goals so that all the people can have equality in accessing different healthcare services (Sibbald, et al 2010). Hence, this is useful in efficient allocation of healthcare resources particularly during the prevalent Covid-19 pandemic.

All the countries face the challenge of allocating finite healthcare resources across the unlimited demand for the healthcare services by their population (Glassman, et al 2012). This is a rationing problem and therefore there has to be effective procedures and agencies for the proper use of these limited resources. The problem of inefficient resource allocation was witnessed in Victoria when there was no state-level plan or agency for allocating healthcare resources during this pandemic (Mitchell, Tumity, and Fuscaldo, August 19, 2020). In the event of shortage of healthcare resources, the national level agency for priority setting can help in allocating the necessary resources in a fair, transparent and ethical manner.

Countries need to have national level agencies for priority setting in the healthcare. This is because it is important to ensure that all the people in the countries have equal access to the healthcare resources. Further, there are health inequalities in the different sections of the society and this agency can help in improving the healthcare access to the disadvantaged groups in the society. Effective priority setting is central for building resilient healthcare systems that can potentially adapt and respond to the changing health demands and needs of a population (van de Pas, et al 2017).

This agency has to be independent as the priority setting is a complex process which is inherently political (Smith, et al 2014). This is involving a range of stakeholders, actors and decision-makers whose actions and motivation may not be aligned perfectly. Hence, this agency has to work independently and in a fair and transparent manner. The differing interests and the motivations are addressed by such an agency by adopting a clear process which is focused on the use of transparency, evidence and participation in the identification of the most important interventions for addressing the health needs of a population.

There is a need for an independent and national agency for this purpose so as to eliminate the unfair practices for allocating necessary resources during the times of some national healthcare emergency such as Covid-19. Further, this will give predictability in the decision-making of healthcare providers when allocating resources. This is because such decisions will be driven by protocols established by this agency. At the meso level (hospital or district level) in a country there are different healthcare organizations which have their own procedures and rules for allocating the necessary resources (Barasa, et al 2015). Most of these resource allocation and priority setting procedures by the healthcare organizations are not known by the public. Therefore, this creates a healthcare disadvantage as the people may not get the resources when they need in times of healthcare crisis. Hence, with a national level and an independent agency for priority setting, this problem can be solved. Citizens and other stakeholders can have the information for the priority setting in the healthcare organizations and this will help in establishing equality, transparency and fairness in healthcare resource allocation procedures.

2. Community Involvement in Priority Setting and Resource Allocation

Priority-setting is a multisectoral and a shared responsibility that is relying on the participatory and inclusive engagement of all the stakeholders including the communities (Terwindt, Rajan, and Soucat, 2016). The communities are affected by the decision-making of the people who impact the implementation of the selected priorities and principles during the priority-setting process. The involvement of the communities is important as the principles for the resource allocation and priority-setting reflects the needs and desires of the populations. Therefore, the independent agency must engage the communities for including the ethical and social principles and values which must guide the resources allocation and priority-setting in a pandemic situation (Littlejohns, et al 2012).

The community people must be involved as their health needs and acceptability for certain healthcare interventions have to be considered when allocating resources. Further, the health policy decision making about priority setting and resource allocation has to consider the ethical beliefs and practices of the communities so that there can be no discrepancies in distribution of healthcare resources during scarcity. In the event of pandemic there has to be a general consensus amongst the communities as to who will avail what healthcare resources. This is important as it will reduce the incidences of unfair and opaque practices of allocating resources. The inclusion of the communities also helps in ensuring that the ethical principles are followed during the healthcare emergency like Covid-19 pandemic. Further, with the inclusion of communities will also ensure that the people are able to access the healthcare resources with equity and fairly.

3. The Values or Principles Underlying Priority-Setting Process in The Pandemic Situation

During a pandemic or crisis situation there is unlimited demand for the finite healthcare resources (Robinson, et al 2012). Hence, there has to be ethical values and principles that are agreed by all the stakeholders for the priority setting processes during the pandemic situation. Some of the principles which should be used for this purpose are as follows:

Transparency- the priority-setting process has to be transparent. The information regarding the allocation of healthcare resources have to be disseminated among the stakeholders.

Equality in provision of care- there should not be variation in care at the meso-level. The healthcare providers must render the resources to the people according to their needs so that maximum lives can be saved.

Evidenced-based- the priority setting process has to be based on research evidence. The priority setting process must consider the evidences for efficient healthcare resources so that the resources can be utilized in a manner where maximum positive impact on the population is attained. The decisions for resource allocation have to be evidence based and rational so that responsibility and accountability can be upheld by the healthcare providers.

Ethical values- the priority-setting has to include the ethical values so that a culturally and ethically safe and appropriate care can be given to the people.

Fairness- there has to be fairness in balancing the competing claims on healthcare resources by the different individuals and patient groups. As far as practical equal treatment must be provided in the same clinical circumstance when the healthcare intervention has been defined.

Equal access- for equal clinical need there must be equal access. The patients must not be unjustifiably disadvantaged or advantaged on the basis of gender, age, financial status, occupation etc.

4. Issues in Priority Setting and The Contribution of Economic Theory as Well as Empirical Evidence

There are several issues in the priority setting. The first issue is that the priority-setting may not satisfy all the interests of the stakeholders and this may not be in the interest of each decision-maker involved in the priority setting process (Norheim, 2017). Priority-setting in healthcare is the ranking of the healthcare services and the ranking of the recipients of these healthcare services. This ranking can be evidence-based and systematic or it can be ad-hoc and arbitrary. Mostly, these ranking is a mixed result of the planned policies, legal regulations, historical budgets, public opinion, financing methods, health professionals’ interests and influence of the patient organizations. This leads to more complexity in the priority setting process for healthcare resources.

Priority-setting faces the second issue for efficiency when there is resources scarcity as in such a situation there can be withholding of interventions for some patients. This is done on the basis that the healthcare resources could be fairly and better spend on some other patients. Such decisions can be unpopular and controversial for the people as there are public disagreement about the procedures for evaluation regarding who gets which healthcare services.

Another issue related to priority setting is that efficiency is not the only goal as it has competing goals to be fulfilled in a health policy. There are concerns about the equal distributions of the healthcare resources and how these add up to give the maximum benefit to a population. Any healthy policy is not only aiming at improving the health of a population as a whole however, it also aims to distribute the health resources in a fair manner. This implies that in the healthcare resource allocation decisions, there are many competing health policy goals which are meant to satisfy various stakeholders. For instance, one can ask for favoring the best outcome from the use of a healthcare resource or should one give it to the people in a fair and equal manner so that benefit can be derived even if it is least significant. In the situation of pandemic like in current Covid-19 one can question of allocating the ventilators to those who have best chances of survival or should one give it a broader group who may have lesser chances of benefiting from this resource (Barrett, et al 2016). Therefore, the priority-setting faces the challenge of balancing equality and rationality when allocating healthcare resources particularly in the times of pandemic like Covid.

There is a lack of good information for the priority-setting. For instance, burden of disease and illness cost points at the problem but do not suggest of any solution. Additionally, there are challenges complexities inherent in the healthcare systems. There are multiple funding mechanism and healthcare services. Further, there is involvement of government at different levels. There is mixture of private and public sector in the healthcare provision. Stakeholders’ interests and the social and ethical goals complicate the priority-setting.

Contributions of economic theory- there are two key economic theories or principles which underlie the healthcare priority setting. These are opportunity cost and the marginal analysis. The opportunity cost deals with the understanding that the investment in some healthcare resources in a certain manner have some opportunity for benefit instead of using the same resources elsewhere. Therefore, this is the key in setting priorities as the costs and benefits for the resource use are measured and then weighed out amongst the alternative choices.

The second principle is of marginal analysis and this about the changing or shifting of the healthcare resource mix (Mitton, Dionne, and Donaldson, 2014). For instance, when the healthcare budget increases, one could ask reasonably as to what are the best ways in which the additional resources should be used. In contrast to it, when the budget decreases as in times of scarcity and pandemic situation, one could ask reasonably as to which are the areas from where the resources can be withdrawn. Further, the when the budget is neither decreasing or increasing the question for re-allocating the resource can be answered. This can allow for cutting back resources in some areas while increasing resources in other areas so that maximum benefit can be provided to the population being served. This concept of margin is essential for the development of the economic approach in the priority-setting. Therefore, with this concept it is aimed that the marginal cost and the marginal benefit ratio remains equal for all the services.

Empirical evidences- the empirical evidences inform the priority-setting process by the decision-makers. As with the empirical and research-based evidences, they are able to respond to the dilemma of scarcity of healthcare resources in a practical and rational manner. However, this process has to be conducted in a way which is evidence-based as far as possible so that reasonable decisions can be made. But the reasonable decision may not be fair and there are competing goals for addressing the views of the stakeholders (Barrett, et al 2016).

Recommendations for the new agency- the new agency can set-up protocols and set guidelines for the resource allocation. This has to be developed with the engagement of all the stakeholders so that the ethics and principles widely believed by a community population are withheld within these protocols. There has to be general consensus in the use of these protocols and guidelines by the healthcare professionals. Further, these protocols must incorporate the research-based and empirical evidence so that there can be efficient use of healthcare resources for the benefit of a population. The use of such protocols should be in such a manner that the decisions of resource allocations taken by the healthcare providers in a similar clinical situation becomes predictable by the service users. Therefore, in this way the new agency can strive to carry out this task in a fair and ethical manner.

References for Priority Setting in Healthcare

Barasa, E. W., Molyneux, S., English, M., & Cleary, S. (2015). Setting healthcare priorities at the macro and meso levels: a framework for evaluation. International journal of health policy and management4(11), 719.

Barrett, D. H., Ortmann, L. H., Dawson, A., Saenz, C., Reis, A., & Bolan, G. (2016). Public health ethics: Cases spanning the globe. Springer Nature.

Chalkidou, K., Glassman, A., Marten, R., Vega, J., Teerawattananon, Y., Tritasavit, N., ... & Culyer, A. J. (2016). Priority-setting for achieving universal health coverage. Bulletin of the World Health Organization94(6), 462.

Chalkidou, K., Glassman, A., Marten, R., Vega, J., Teerawattananon, Y., Tritasavit, N., ... & Culyer, A. J. (2016). Priority-setting for achieving universal health coverage. Bulletin of the World Health Organization94(6), 462.

Glassman, A., Chalkidou, K., Giedion, U., Teerawattananon, Y., Tunis, S., Bump, J. B., & Pichon-Riviere, A. (2012). Priority-setting institutions in health: recommendations from a center for global development working group. Global Heart7(1), 13-34.

Littlejohns, P., Weale, A., Chalkidou, K., Teerwattananon, Y., Faden, R., Ahn, J., ... & Lee, S. M. (2012). Social values and healthcare priority setting in Korea. Journal of health organization and management.

Mitchell, L., Tumity, E. & Fuscaldo, G. (August 19, 2020). In Victoria, whether you get an ICU bed could depend on the hospital. [ONLINE] Available at https://theconversation.com/in-victoria-whether-you-get-an-icu-bed-could-depend-on-the-hospital-144209

Mitton, C., Dionne, F., & Donaldson, C. (2014). Managing healthcare budgets in times of austerity: the role of program budgeting and marginal analysis. Applied health economics and health policy12(2), 95-102.

Robinson, S., Williams, I., Dickinson, H., Freeman, T., & Rumbold, B. (2012). Priority-setting and rationing in healthcare: evidence from the English experience. Social science & medicine75(12), 2386-2393.

Sibbald, S. L., Gibson, J. L., Singer, P. A., Upshur, R., & Martin, D. K. (2010). Evaluating priority setting success in healthcare: a pilot study. BMC health services research10(1), 131.

Smith, N., Mitton, C., Davidson, A., & Williams, I. (2014). A politics of priority setting: Ideas, interests and institutions in healthcare resource allocation. Public Policy and Administration29(4), 331-347.

Terwindt, F., Rajan, D., & Soucat, A. (2016). Priority-setting for national health policies, strategies and plans. Strategizing national health in the 21st century: a handbook71.

van de Pas, R., Ashour, M., Kapilashrami, A., & Fustukian, S. (2017). Interrogating resilience in health systems development. Health policy and planning32(suppl_3), iii88-iii90.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

Get It Done! Today

Applicable Time Zone is AEST [Sydney, NSW] (GMT+11)
Not Specific >5000
  • 1,212,718Orders

  • 4.9/5Rating

  • 5,063Experts

Highlights

  • 21 Step Quality Check
  • 2000+ Ph.D Experts
  • Live Expert Sessions
  • Dedicated App
  • Earn while you Learn with us
  • Confidentiality Agreement
  • Money Back Guarantee
  • Customer Feedback

Just Pay for your Assignment

  • Turnitin Report

    $10.00
  • Proofreading and Editing

    $9.00Per Page
  • Consultation with Expert

    $35.00Per Hour
  • Live Session 1-on-1

    $40.00Per 30 min.
  • Quality Check

    $25.00
  • Total

    Free
  • Let's Start

Get
500 Words Free
on your assignment today

Browse across 1 Million Assignment Samples for Free

Explore MASS
Order Now

Request Callback

My Assignment Services- Whatsapp Tap to ChatGet instant assignment help

Hire Certified Experts
Ask your Question
Need Assistance on your
existing assignment order?