Apantaku Glory O, Kapiriri Lydia, Norheim Ole F, de Azevedo Ingrid Cardoso Couto, Kim Dan, Hensher Martin, Ananthapavan Jaithri, Bhopal Anand, MacNeill Andrea J, Sherman Jodi D, Mitton Craig
Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, Canada.
McMaster University, Hamilton, Canada.
Appl Health Econ Health Policy. 2025 Jun 24. doi: 10.1007/s40258-025-00980-x.
The realities of ecosystem breakdown and climate change pose a significant threat to the health of individuals around the world, disproportionately affecting poor and vulnerable populations. Every sector in society, including healthcare, needs to be engaged in the tremendous collective effort and transformational change needed to limit global warming. We see priority setting as having a key role to play in reallocating existing budgets within healthcare systems whilst at the same time being used to facilitate sustainable and more efficient resource allocation across countries. Priority setting looks to fairly distribute resources with the goal of improving patient and population health outcomes. However, these goals can be broadened to include consideration of environmental impact based on our understanding of the necessity of emissions reduction to address the climate crisis and promote population health. In this paper, we introduce key concepts of priority setting and identify the interplay between priority setting and the realities of resource scarcity in the realm of planetary healthcare. We propose that applying priority-setting principles could serve at least three goals; (1) protect and improve health outcomes; (2) limit unnecessary and marginal care; and (3) facilitate a just transition to a sustainable healthcare system.
生态系统崩溃和气候变化的现实对世界各地个人的健康构成了重大威胁，对贫困和弱势群体的影响尤为严重。社会的每个部门，包括医疗保健部门，都需要参与到限制全球变暖所需的巨大集体努力和变革中来。我们认为，确定优先事项在重新分配医疗保健系统内的现有预算方面可发挥关键作用，同时还可用于促进各国可持续和更高效的资源分配。确定优先事项旨在公平分配资源，以改善患者和人群的健康结果。然而，基于我们对减排以应对气候危机和促进人群健康必要性的理解，这些目标可以扩大到包括对环境影响的考虑。在本文中，我们介绍了确定优先事项的关键概念，并确定了在全球医疗保健领域确定优先事项与资源稀缺现实之间的相互作用。我们建议应用确定优先事项的原则至少可以实现三个目标：（1）保护和改善健康结果；（2）限制不必要和边际护理；（3）促进向可持续医疗保健系统的公正过渡。
