Rationing in healthcare—a scoping review

Abstract

Healthcare rationing has been the subject of numerous debates and concerns in the field of health economics in recent years. It is a concept which refers to the allocation of scarce healthcare resources and involves the use of different approaches to the delivery of health services and patient care. Regardless of the approach used, healthcare rationing fundamentally involves withholding potentially beneficial programs and/or treatments from certain people. As the demands placed on health services continue to rise and with that significant increases to the cost, healthcare rationing has become increasingly popular and is deemed necessary for the delivery of affordable, patient-care services. However, public discourse on this issue has largely been centered on ethical considerations with less focus on economic rationality. Establishing the economic rationality of healthcare rationing is essential in healthcare decision-making and consideration of its adoption by healthcare authorities and organizations. This scoping review of seven articles demonstrates that the economic rationality of healthcare rationing is the scarcity of healthcare resources amidst increased demand and costs. Therefore, supply, demand, and benefits are at the core of healthcare rationing practices and influence decisions on its suitability. Given the increased costs of care and resource scarcity, healthcare rationing is a suitable practice towards ensuring healthcare resources are allocated to people in a rational, equitable, and cost-effective manner. The rising costs and demands for care place significant pressure on healthcare authorities to identify suitable strategies for the allocation of healthcare resources. Healthcare rationing as a priority-setting strategy would support healthcare authorities identify mechanisms to allocate scarce resources in a cost-effective manner. When used in the context of a priority-setting approach, healthcare rationing helps healthcare organizations and practitioners to ensure that patient populations achieve maximum benefits at reasonable costs. It represents a fair allocation of healthcare resources to all populations, especially in low-income settings.

Assessing social protection influence on health status in the European Union

“…The efficiency of healthcare services has been the subject of extensive debates and concerns in health economics in recent years ( 6 ). This action involves providing accessible and patient-centered medical care by allocating limited healthcare resources and rejecting certain potentially beneficial programs or treatments for specific individuals.…”

“…This action involves providing accessible and patient-centered medical care by allocating limited healthcare resources and rejecting certain potentially beneficial programs or treatments for specific individuals. It is a suitable practice to ensure a rational, equitable, and cost-effective allocation of healthcare resources ( 6 ). Rising healthcare costs and demands have placed considerable pressure on health authorities to develop effective strategies for resource allocation.…”

“…In this context, optimizing these systems becomes crucial to ensure optimal utilization of limited resources and providing quality services at sustainable costs. Economic evaluation plays a vital role in the decision-making process for healthcare organizations and practitioners, providing valuable information regarding the impact and effectiveness of various policies and programs ( 6 ).…”

“…Academic literature ( 1 , 6 ) signals financial allocations for healthcare and social protection services imbalances. Social protection must include easy and free access to healthcare services for vulnerable populations exposed to poverty and aging to promote equitable healthcare access.…”

“…Rising healthcare costs and demands have placed considerable pressure on health authorities to develop effective strategies for resource allocation. Efficient healthcare services require identifying mechanisms for costeffectively allocating limited resources and ensuring maximum benefits for patient populations (6)(7)(8)(9).…”