National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Institute of Heart Diseases, University Hospital, Wroclaw, Poland.
Front Public Health. 2023 Jun 21;11:1160691. doi: 10.3389/fpubh.2023.1160691. eCollection 2023.
Healthcare rationing has been the subject of numerous debates and concerns in the field of health economics in recent years. It is a concept which refers to the allocation of scarce healthcare resources and involves the use of different approaches to the delivery of health services and patient care. Regardless of the approach used, healthcare rationing fundamentally involves withholding potentially beneficial programs and/or treatments from certain people. As the demands placed on health services continue to rise and with that significant increases to the cost, healthcare rationing has become increasingly popular and is deemed necessary for the delivery of affordable, patient-care services. However, public discourse on this issue has largely been centered on ethical considerations with less focus on economic rationality. Establishing the economic rationality of healthcare rationing is essential in healthcare decision-making and consideration of its adoption by healthcare authorities and organizations. This scoping review of seven articles demonstrates that the economic rationality of healthcare rationing is the scarcity of healthcare resources amidst increased demand and costs. Therefore, supply, demand, and benefits are at the core of healthcare rationing practices and influence decisions on its suitability. Given the increased costs of care and resource scarcity, healthcare rationing is a suitable practice towards ensuring healthcare resources are allocated to people in a rational, equitable, and cost-effective manner. The rising costs and demands for care place significant pressure on healthcare authorities to identify suitable strategies for the allocation of healthcare resources. Healthcare rationing as a priority-setting strategy would support healthcare authorities identify mechanisms to allocate scarce resources in a cost-effective manner. When used in the context of a priority-setting approach, healthcare rationing helps healthcare organizations and practitioners to ensure that patient populations achieve maximum benefits at reasonable costs. It represents a fair allocation of healthcare resources to all populations, especially in low-income settings.
近年来，医疗保健资源配给一直是卫生经济学领域众多争论和关注的主题。它是指对稀缺医疗资源的分配，涉及使用不同的方法来提供卫生服务和患者护理。无论使用哪种方法，医疗保健资源配给都从根本上涉及到对某些人拒绝潜在有益的项目和/或治疗。随着对医疗服务的需求持续增加，成本显著增加，医疗保健资源配给变得越来越流行，并被认为是提供负担得起的、以患者为中心的医疗服务所必需的。然而，公众对这个问题的讨论主要集中在伦理考虑上，而对经济合理性的关注较少。在医疗保健决策中，确定医疗保健资源配给的经济合理性至关重要，同时也需要考虑医疗保健当局和组织是否采用这种方法。对七篇文章的范围综述表明，医疗保健资源配给的经济合理性在于医疗资源的稀缺性，而需求和成本却在不断增加。因此，供应、需求和效益是医疗保健资源配给实践的核心，影响着对其适用性的决策。鉴于护理成本的增加和资源的稀缺性，医疗保健资源配给是一种确保以合理、公平和具有成本效益的方式分配医疗资源的合适做法。不断增加的护理成本和需求给医疗保健当局带来了巨大的压力，要求他们确定合适的策略来分配医疗资源。将医疗保健资源配给作为一种优先排序策略，可以支持医疗保健当局以具有成本效益的方式确定分配稀缺资源的机制。当在优先排序方法的背景下使用时，医疗保健资源配给可以帮助医疗保健组织和从业者确保患者群体以合理的成本获得最大的效益。它代表了对所有人群，特别是在低收入环境中，公平分配医疗资源。
