Publication:
The Economics of Priority Setting for Health Care : A Literature Review

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dc.contributor.authorHauck, Katharina
dc.contributor.authorSmith, Peter C.
dc.contributor.authorGoddard, Maria
dc.date.accessioned2013-05-30T18:04:43Z
dc.date.available2013-05-30T18:04:43Z
dc.date.issued2004-09
dc.description.abstractThis report provides a review of the literature on priority setting in healthcare. It adopts an economic perspective on the problem of choosing the optimal portfolio of programs that can be afforded from a limited national healthcare budget. The traditional economic approach, proposes maximizing health gain (however measured) subject to a budget constraint, which implies ranking programs according to their cost-effectiveness ratio. However, our critical review suggests that this traditional approach is subject to three important difficulties: limitations in economic evaluation methodology, incorporating equity principles, and practical constraints. These suggest a need for a fundamental rethink of the role of cost-effectiveness analysis in priority setting. Methodological concerns include identifying whose perspective to adopt, the generalizability of results to multiple settings, the treatment of uncertainty and timing, and the treatment of interactions between programs. Most equity considerations can be captured in two broad headings: equity related to some concept of need and equity related to access to services. In principle equity concerns can be incorporated into an economic approach to priority setting with relative ease. However we find that many contributions to the debate on equity concepts are theoretical and remote from practical implementation issues. The traditional cost-effectiveness approach generally ignores the numerous practical constraints arising from the political, institutional, and environmental context in which priority setting takes place. These include the influence of interest groups, the transaction costs associated with policy changes, and the interactions between the provision and financing of health services. We find that treatment of such political economy perspectives is the least well-developed aspect of the priority setting literature and suggest some rudimentary models that could serve as a starting point for analysisen
dc.identifierhttp://documents.worldbank.org/curated/en/2004/09/5584467/economics-priority-setting-health-care-literature-review
dc.identifier.doi10.1596/13700
dc.identifier.urihttps://hdl.handle.net/10986/13700
dc.languageEnglish
dc.language.isoen_US
dc.publisherWorld Bank, Washington, DC
dc.relation.ispartofseriesHNP discussion paper series;
dc.rightsCC BY 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectHEALTH CARE REFORM
dc.subjectHEALTH CARE
dc.subjectBUDGET CONSTRAINTS
dc.subjectHEALTH CARE FINANCE
dc.subjectABATEMENT
dc.subjectACCESS TO HEALTH CARE
dc.subjectADVERSE EFFECTS
dc.subjectALLOCATIVE EFFICIENCY
dc.subjectALTERNATIVE POLICIES
dc.subjectBENEFIT ANALYSIS
dc.subjectBUDGET CONSTRAINTS
dc.subjectCOMPLEX TASK
dc.subjectCONSUMERS
dc.subjectCOST EFFECTIVENESS
dc.subjectDEVELOPING COUNTRIES
dc.subjectDISTRIBUTION OF WEALTH
dc.subjectDONOR AGENCIES
dc.subjectECONOMIC ANALYSIS
dc.subjectECONOMIC EVALUATION
dc.subjectECONOMIC POLICY
dc.subjectECONOMIC THEORY
dc.subjectECONOMISTS
dc.subjectEXPENDITURES
dc.subjectEXTERNALITIES
dc.subjectFAMILY CARE
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE FINANCE
dc.subjectHEALTH CARE FINANCING
dc.subjectHEALTH CARE RESOURCES
dc.subjectHEALTH CARE SYSTEMS
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH GAIN
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH POLICY
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICES
dc.subjectHEALTH STATUS
dc.subjectHEALTH SYSTEM
dc.subjectHUMAN CAPITAL
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectINCOME
dc.subjectINCREMENTAL COSTS
dc.subjectINSURANCE
dc.subjectINTERVENTION
dc.subjectISOLATION
dc.subjectLESSONS LEARNED
dc.subjectMALARIA
dc.subjectMARGINAL ANALYSIS
dc.subjectMEDICAL EQUIPMENT
dc.subjectMEDICAL TECHNOLOGIES
dc.subjectMORBIDITY
dc.subjectNUTRITION
dc.subjectOPPORTUNITY COSTS
dc.subjectOPTIMIZATION
dc.subjectPATIENTS
dc.subjectPOLICY ANALYSIS
dc.subjectPOLITICAL ECONOMY
dc.subjectPRESENT VALUE
dc.subjectPRODUCTIVITY
dc.subjectPROMOTING HEALTH
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH PROGRAMS
dc.subjectPUBLIC SECTOR
dc.subjectRESOURCE ALLOCATION
dc.subjectSCARCE RESOURCES
dc.subjectSOCIAL POLICY
dc.subjectTRANSACTION COSTS
dc.subjectTUBERCULOSIS
dc.subjectUNCERTAINTY
dc.subjectWAGES
dc.subjectWEALTH
dc.subjectWELFARE ECONOMICS HEALTH CARE REFORM
dc.subjectHEALTH CARE
dc.subjectBUDGET CONSTRAINTS
dc.subjectHEALTH CARE FINANCE
dc.titleThe Economics of Priority Setting for Health Care : A Literature Reviewen
dspace.entity.typePublication
okr.crosscuttingsolutionareaGender
okr.date.doiregistration2025-05-05T11:46:53.300249Z
okr.doctypePublications & Research::Working Paper
okr.doctypePublications & Research
okr.docurlhttp://documents.worldbank.org/curated/en/2004/09/5584467/economics-priority-setting-health-care-literature-review
okr.globalpracticeHealth, Nutrition, and Population
okr.guid697461468782089784
okr.guid896691468780616417
okr.identifier.externaldocumentum000112742_20050204160727
okr.identifier.internaldocumentum5584467
okr.identifier.report28878
okr.language.supporteden
okr.pdfurlhttp://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2005/02/04/000112742_20050204160727/Rendered/PDF/288780revised0.pdfen
okr.topicHealth Monitoring and Evaluation
okr.topicEconomic Theory and Research
okr.topicHealth Systems Development and Reform
okr.topicEnvironmental Economics and Policies
okr.topicGender::Gender and Health
okr.unitHealth, Nutrition, and Population
okr.volume1 of 1
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