The Problem of Discrimination in Health Care Priority Setting
Hadorn, David C.
JAMA. 1992 Sep 16; 268(11): 1454-1459.
Increasingly stringent fiscal restrictions on the scope of medical services available to patients have resulted in calls for explicit health care priority setting. Several commentators have called for the application of decision-analytic principles to such efforts, which would assign services priority based on the extent to which they produce preferred health outcomes. The Oregon Medicaid exercise is an example of such a process. An important challenge to these utilitarian efforts is the need to avoid discrimination against people with medical disabilities. Both of the key elements entailed by decision-analytic approaches to priority setting -- estimation of outcomes and assignment of values to those outcomes -- are vulnerable to charges of discrimination, primarily because both the medical outcomes expected in disabled individuals and the values they place on those outcomes may differ from the general public. Priority-setting efforts must proceed carefully to avoid the appearance (and reality) of discrimination.
Showing items related by title, author, creator and subject.
Hadorn, David C. (1991)Public values must play a substantial role in any attempt to deal with the health care resource allocation problem. This article examines how preferences for the health outcomes of care (e.g. improved or worsened physical ...
Hadorn, David C. (1991-05-01)The Oregon Health Services Commission recently completed work on its principal charge: creation of a prioritized list of health care services, ranging from the most important to the least important. Oregon's draft priority ...