Priority-setting and rationing in German health care

Health Policy ◽  
1999 ◽  
Vol 50 (1-2) ◽  
pp. 71-90 ◽  
Author(s):  
Reinhard Busse
Health Policy ◽  
2009 ◽  
Vol 91 (3) ◽  
pp. 219-228 ◽  
Author(s):  
Craig Mitton ◽  
Neale Smith ◽  
Stuart Peacock ◽  
Brian Evoy ◽  
Julia Abelson

2016 ◽  
Vol 8 (10) ◽  
pp. 212
Author(s):  
Hakimeh Mostafavi ◽  
Arash Rashidian ◽  
Mohammad Arab ◽  
Mohammad R. V. Mahdavi ◽  
Kioomars Ashtarian

<p><strong>Background:</strong> Health systems, as part of the social system, consider public values. This study was conducted to examine the role of social values in the health priority setting in the Iranian health system.</p><p><strong>Methods:</strong> In this qualitative case study, three main data sources were used: literature, national documents, and key informants who were purposefully selected from health care organizations and other related institutions. Data was analyzed and interpreted using the Clark-Weale Framework.</p><p><strong>Results:</strong> According to our results, the public indirectly participates in decision-making. The public representatives participate in the meetings of the health priority setting as parliament members, representatives of some unions, members of the city council, and donors. The transparency of the decisions and the accountability of the decision makers are low. Decision makers only respond to complaints of the Audit Court and the Inspection Organization. Individual choice, although respected in hospitals and clinics, is limited in health care networks because of the referral system. Clinical effectiveness is considered in insurance companies and some hospitals. There are no technical abilities to determine the cost-effectiveness of health technologies; however, some international experiences are employed. Equity and solidarity are considered in different levels of the health system.</p><p><strong>Conclusion:</strong> Social values are considered in the health priority decisions in limited ways. It seems that the lack of an appropriate value-based framework for priority setting and also the lack of public participation are the major defects of the health system. It is recommended that health policymakers invite different groups of people and stakeholders for active involvement in health priority decisions. </p>


2000 ◽  
Vol 13 (6) ◽  
pp. 254-258 ◽  
Author(s):  
Johannes Moeller ◽  
Jochen Breinlinger‐O’Reilly ◽  
John Elser

2007 ◽  
Vol 2 (2) ◽  
pp. 153-171 ◽  
Author(s):  
SANDRA JANSSON

AbstractThis paper aims to describe the priority-setting procedure for new original pharmaceuticals practiced by the Swedish Pharmaceutical Benefits Board (LFN), to analyse the outcome of the procedure in terms of decisions and the relative importance of ethical principles, and to examine the reactions of stakeholders. All the ‘principally important’ decisions made by the LFN during its first 33 months of operation were analysed. The study is theoretically anchored in the theory of fair and legitimate priority-setting procedures by Daniels and Sabin, and is based on public documents, media articles, and semi-structured interviews. Only nine cases resulted in a rejection of a subsidy by the LFN and 15 in a limited or conditional subsidy. Total rejections rather than limitations gave rise to actions by stakeholders. Primarily, the principle of cost-effectiveness was used when limiting/conditioning or totally rejecting a subsidy. This study suggests that implementing a priority-setting process that fulfils the conditions of accountability for reasonableness can result in a priority-setting process which is generally perceived as fair and legitimate by the major stakeholders and may increase social learning in terms of accepting the necessity of priority setting in health care. The principle of cost-effectiveness increased in importance when the demand for openness and transparency increased.


2015 ◽  
Vol 43 (2) ◽  
pp. 191-194 ◽  
Author(s):  
Carolin Mäding ◽  
Carolin Jacob ◽  
Carola Münch ◽  
Katharina von Lindeman ◽  
Jörg Klewer ◽  
...  

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