Document Detail


Explicit and implicit rationing: taking responsibility and avoiding blame for health care choices.
MedLine Citation:
PMID:  11467274     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Rationing health care in publicly funded health care systems is becoming more challenging because of the growing gap between the possibility of effective medical intervention and limited resources. This poses both an economic challenge and a political puzzle. On the basis of experience in those systems that have adopted a systematic approach to rationing, it can be suggested that the dilemmas involved should be addressed by strengthening both the information base to support decisions and the institutional framework in which decisions are taken. The contribution both of experts and of lay people is needed to inform decision-making, and the processes adopted need to allow for this as well as being transparent and accountable. In practice, rationing is likely to combine explicit and implicit decision-making and to result in the exclusion of services at the margins and the development of guidelines in the mainstream. The politics of rationing may favour muddling through and the evasion of responsibility but this will be difficult to sustain in an environment in which public awareness of decision-making in health care is growing.
Authors:
C Ham; A Coulter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of health services research & policy     Volume:  6     ISSN:  1355-8196     ISO Abbreviation:  J Health Serv Res Policy     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-24     Completed Date:  2001-09-06     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  9604936     Medline TA:  J Health Serv Res Policy     Country:  England    
Other Details:
Languages:  eng     Pagination:  163-9     Citation Subset:  E; H    
Affiliation:
Health Services Management Centre, University of Birmingham, 40 Edgbaston Park Road, Birmingham B15 2RT, UK.
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MeSH Terms
Descriptor/Qualifier:
Decision Making, Organizational*
Europe
Great Britain
Health Care Rationing*
Health Policy
Humans
New Zealand
Social Responsibility*
State Medicine / standards

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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