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Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall

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  • E. Wetering

    ()

  • E. Stolk
  • N. Exel
  • W. Brouwer

Abstract

Economic evaluations are increasingly used to inform decisions regarding the allocation of scarce health care resources. To systematically incorporate societal preferences into these evaluations, quality-adjusted life year gains could be weighted according to some equity principle, the most suitable of which is a matter of frequent debate. While many countries still struggle with equity concerns for priority setting in health care, the Netherlands has reached a broad consensus to use the concept of proportional shortfall. Our study evaluates the concept and its support in the Dutch health care context. We discuss arguments in the Netherlands for using proportional shortfall and difficulties in transitioning from principle to practice. In doing so, we address universal issues leading to a systematic consideration of equity concerns for priority setting in health care. The article thus has relevance to all countries struggling with the formalization of equity concerns for priority setting. Copyright The Author(s) 2013

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Bibliographic Info

Article provided by Springer in its journal The European Journal of Health Economics.

Volume (Year): 14 (2013)
Issue (Month): 1 (February)
Pages: 107-115

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Handle: RePEc:spr:eujhec:v:14:y:2013:i:1:p:107-115

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Web page: http://link.springer.de/link/service/journals/10198/index.htm

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Related research

Keywords: Proportional shortfall; Priority setting; Equity; Social value; Resource allocation; I10; I18;

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References

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  15. Shah, Koonal K., 2009. "Severity of illness and priority setting in healthcare: A review of the literature," Health Policy, Elsevier, vol. 93(2-3), pages 77-84, December.
  16. Bethan George & Anthony Harris & Andrew Mitchell, 2001. "Cost-Effectiveness Analysis and the Consistency of Decision Making: Evidence from Pharmaceutical Reimbursement in Australia (1991 to 1996)," PharmacoEconomics, Springer Healthcare | Adis, vol. 19(11), pages 1103-1109.
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Cited by:
  1. Nord, Erik & Johansen, Rune, 2014. "Concerns for severity in priority setting in health care: A review of trade-off data in preference studies and implications for societal willingness to pay for a QALY," Health Policy, Elsevier, vol. 116(2), pages 281-288.
  2. Erik Nord & Jose Luis Pinto & Jeff Richardson & Paul Menzel & Peter Ubel, 1999. "Incorporating societal concerns for fairness in numerical valuations of health programmes," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 25-39.

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