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The nature of procedural preferences for health-care rationing decisions

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  • Wailoo, Allan
  • Anand, Paul

Abstract

Substantial debate on the appropriate foundations of economic evaluation in health-care has been conducted between welfarists and non-welfarists in the health economics literature. This has focussed on defining and measuring appropriate outcomes. However, there has been little discussion of the importance of procedures. This paper examines six dimensions of procedure in relation to health-care rationing which are drawn from existing literature and previous empirical investigation. A survey of the general public was used to test for preferences for each dimension of procedure. Results show that for each dimension the importance differed according to the level of decision-making (we tested decision-making at the level of the individual doctor, health authority and government). We identified three distinct clusters of respondents who can be broadly described as "proceduralists" (47%), "pluralists" (15%) and "anti-consequentialists" (38%). The paper concludes that consequentialism is insufficient to provide the conceptual framework that public decision-making in health requires, although this does not mean that consequences are unimportant.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 60 (2005)
Issue (Month): 2 (January)
Pages: 223-236

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Handle: RePEc:eee:socmed:v:60:y:2005:i:2:p:223-236

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Related research

Keywords: Health-care rationing Empirical social choice Procedural fairness;

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Cited by:
  1. Adam Oliver, 2005. "The English National Health Service: 1979-2005," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S75-S99.
  2. Paul Anand, 2002. "The Integration of Claims to Health-Care: a Programming Approach," Open Discussion Papers in Economics 45, The Open University, Faculty of Social Sciences, Department of Economics.
  3. Aki Tsuchiya & Paul Dolan, 2009. "Equality of what in health? Distinguishing between outcome egalitarianism and gain egalitarianism," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 147-159.

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