Priority-Setting Processes for Expensive Treatments for Chronic Diseases

Sakuma, Yuna; Glassman, Amanda; Vaca, Claudia

doi:10.1596/978-1-4648-0518-9_ch21

Cited by 5 publications

(1 citation statement)

References 15 publications

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“…1,2 Under this framework, priority-setting methods and policies are emerging as tools of public choices, especially, for governments to allocate resources in the health sector. [3][4][5][6][7][8][9][10] As previous studies have suggested, explicit and robust priority setting can release resources 'from cost-ineffective technologies towards more cost-effective ones or towards covering more people'. 11 Priority setting, as a matter of fact, can contribute to defining the least damaging and most explicit ways of cutting costs and achieving universal health coverage under National Health Services.…”

Section: Introductionmentioning

confidence: 99%

Setting priorities in health: The managers' perspectives versus general public

Araújo,

Reis,

Borges

et al. 2023

International Journal of Care Coordination

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Introduction Decision-makers are constantly confronted with the need of balancing limited resources while establishing rationing criteria in health care system. However, there is an emerging trend in involving citizens in rationing debates as mechanism to assuring legitimacy in the decision-making process. This paper aims to explore citizens’ opinions on priority setting in health care access in comparison with the perspectives of managers. Methods An online questionnaire was used to collect the data. A logistic regression was applied to evaluate factors that shape the prioritisation of groups in access to health care services. The collected data comprehends 400 individuals, aged 18 years old and over living in continental Portugal. Results The study results reveal that managers and the general public, in the context of limited resources, both agree with the need to prioritise some groups over others in access to health care services. The priority groups would include the elderly, children, and people with chronic conditions. The most outstanding finding is that managers prefer children as their first priority group against the general public who has considered as top priority the elder ones. Discussion This study identified which stakeholders are prone to be included in decision-making processes for effective priority-setting models in the health care systems and evaluated their preferences.

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Section: Introductionmentioning

confidence: 99%

Setting priorities in health: The managers' perspectives versus general public

Araújo,

Reis,

Borges

et al. 2023

International Journal of Care Coordination

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Paying for Hemodialysis in Kerala, India: A Description of Household Financial Hardship in the Context of Medical Subsidy

Bradshaw

Gracious

Narayanan

et al. 2019

Kidney International Reports

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Introduction: Many low-and middle-income countries are implementing strategies to increase dialysis availability as growing numbers of people reach end-stage renal disease. Despite efforts to subsidize care, the economic sustainability of chronic dialysis in these settings remains uncertain. We evaluated the association of medical subsidy with household financial hardship related to hemodialysis in Kerala, India, a state with high penetrance of procedure-based subsidies for patients on dialysis. Methods: Patients on maintenance hemodialysis at 15 facilities in Kerala were administered a questionnaire that ascertained demographics, dialysis details, and household finances. We estimated direct and indirect costs of hemodialysis, and described the use of medical subsidy. We evaluated whether presence of subsidy (private, charity, or government-sponsored) was associated with lower catastrophic health expenditure (defined as $40% of nonsubsistence expenditure spent on dialysis) or distress financing. Results: Of the 835 patients surveyed, 759 (91%) reported their households experienced catastrophic health expenditure, and 644 (77%) engaged in distress financing. Median dialysis-related expenditure was 80% (25th-75th percentile: 60%-90%) of household nonsubsistence expenditure. Government subsidies were used by 238 (29%) of households, 139 (58%) of which were in the lowest income category. Catastrophic health expenditure was present in 215 (90%) of households receiving government subsidy and 332 (93%) without subsidy. Conclusions: Provision of medical subsidy in Kerala, India was not associated with lower rates of household financial hardship related to long-term hemodialysis therapy. Transparent counseling on impending costs and innovative strategies to mitigate household financial distress are necessary for persons with end-stage renal disease in resource-limited settings.

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Cushioning the economic burden of chronic kidney disease for patients in LMICs: The heightened need for a government-driven financial support policy

Okoro

2021

Health Policy and Technology

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Priority-Setting Processes for Expensive Treatments for Chronic Diseases

Cited by 5 publications

References 15 publications

Setting priorities in health: The managers' perspectives versus general public

Setting priorities in health: The managers' perspectives versus general public

Paying for Hemodialysis in Kerala, India: A Description of Household Financial Hardship in the Context of Medical Subsidy

Cushioning the economic burden of chronic kidney disease for patients in LMICs: The heightened need for a government-driven financial support policy

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