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Criteria for the procedural fairness of health financing decisions: a scoping review

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Listed:
  • Dale, Elina
  • Peacocke, Elizabeth F.
  • Movik, Espen
  • Voorhoeve, Alex
  • Ottersen, Trygve
  • Kurowski, Christoph
  • Evans, David B.
  • Norheim, Ole Frithjof
  • Gopinathan, Unni

Abstract

Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which is widely applied to assess procedural fairness, has primarily been used in priority-setting for purchasing decisions, with revenue mobilization and pooling receiving limited attention. Furthermore, the sufficiency of the A4R framework’s four criteria (publicity, relevance, revisions and appeals, and enforcement) has been questioned. Moreover, research in political theory and public administration (including deliberative democracy), public finance, environmental management, psychology, and health financing has examined the key features of procedural fairness, but these insights have not been synthesized into a comprehensive set of criteria for fair decision-making processes in health financing. A systematic study of how these criteria have been applied in decision-making situations related to health financing and in other areas is also lacking. This paper addresses these gaps through a scoping review. It argues that the literature across many disciplines can be synthesized into 10 core criteria with common philosophical foundations. These go beyond A4R and encompass equality, impartiality, consistency over time, reason-giving, transparency, accuracy of information, participation, inclusiveness, revisability and enforcement. These criteria can be used to evaluate and guide decision-making processes for financing UHC across different country income levels and health financing arrangements. The review also presents examples of how these criteria have been applied to decisions in health financing and other sectors.

Suggested Citation

  • Dale, Elina & Peacocke, Elizabeth F. & Movik, Espen & Voorhoeve, Alex & Ottersen, Trygve & Kurowski, Christoph & Evans, David B. & Norheim, Ole Frithjof & Gopinathan, Unni, 2023. "Criteria for the procedural fairness of health financing decisions: a scoping review," LSE Research Online Documents on Economics 119799, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:119799
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    1. Kapiriri, Lydia & Norheim, Ole F. & Martin, Douglas K., 2009. "Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making?," Social Science & Medicine, Elsevier, vol. 68(4), pages 766-773, February.
    2. World Bank, 2008. "Brazil : Toward a More Inclusive and Effective Participatory Budget in Porto Alegre, Volume 2. Annexes," World Bank Publications - Reports 8040, The World Bank Group.
    3. Littlejohns, Peter & Chalkidou, Kalipso, 2016. "Information will be the key to successful implementation," Health Economics, Policy and Law, Cambridge University Press, vol. 11(1), pages 85-89, January.
    4. Gibson, Jennifer L. & Martin, Douglas K. & Singer, Peter A., 2005. "Priority setting in hospitals: Fairness, inclusiveness, and the problem of institutional power differences," Social Science & Medicine, Elsevier, vol. 61(11), pages 2355-2362, December.
    5. Weale, Albert, 2016. "The path from nowhere?," Health Economics, Policy and Law, Cambridge University Press, vol. 11(1), pages 97-102, January.
    6. Miller, Arthur H. & Listhaug, Ola, 1990. "Political Parties and Confidence in Government: A Comparison of Norway, Sweden and the United States," British Journal of Political Science, Cambridge University Press, vol. 20(3), pages 357-386, July.
    7. World Bank, 2008. "Brazil : Toward a More Inclusive and Effective Participatory Budget in Porto Alegre, Volume 1. Main Report," World Bank Publications - Reports 8042, The World Bank Group.
    8. World Bank, 2021. "Investing in Human Capital for a Resilient Recovery," World Bank Publications - Reports 35840, The World Bank Group.
    9. Street, Jackie & Duszynski, Katherine & Krawczyk, Stephanie & Braunack-Mayer, Annette, 2014. "The use of citizens' juries in health policy decision-making: A systematic review," Social Science & Medicine, Elsevier, vol. 109(C), pages 1-9.
    10. Gallego, Gisselle & Taylor, Susan Joyce & Brien, Jo-anne Elizabeth, 2007. "Priority setting for high cost medications (HCMs) in public hospitals in Australia: A case study," Health Policy, Elsevier, vol. 84(1), pages 58-66, November.
    11. Jansson, Sandra, 2007. "Implementing accountability for reasonableness – the case of pharmaceutical reimbursement in Sweden," Health Economics, Policy and Law, Cambridge University Press, vol. 2(2), pages 153-171, April.
    12. Cornwall, Andrea & Shankland, Alex, 2008. "Engaging citizens: Lessons from building Brazil's national health system," Social Science & Medicine, Elsevier, vol. 66(10), pages 2173-2184, May.
    13. Ole F Norheim & Joelle Abi-Rached & Liam K Bright & Kristine Bærøe & Octávio L. M Ferraz & Siri Gloppen & Alex Voorhoeve, 2021. "Difficult trade-offs in response to COVID-19. The case for open and inclusive decision making," SciencePo Working papers Main hal-03566528, HAL.
    14. Petricca, Kadia & Bekele, Asfaw & Berta, Whitney & Gibson, Jennifer & Pain, Clare, 2018. "Advancing methods for health priority setting practice through the contribution of systems theory: Lessons from a case study in Ethiopia," Social Science & Medicine, Elsevier, vol. 198(C), pages 165-174.
    15. Ole F Norheim & Joelle Abi-Rached & Liam K Bright & Kristine Bærøe & Octávio L. M Ferraz & Siri Gloppen & Alex Voorhoeve, 2021. "Difficult trade-offs in response to COVID-19. The case for open and inclusive decision making," Post-Print hal-03566528, HAL.
    16. World Bank, 2008. "Brazil - Toward a More Inclusive and Effective Participatory Budget in Porto Alegre : Volume 1. Main report," World Bank Publications - Reports 6275, The World Bank Group.
    17. Kutzin, Joseph, 2001. "A descriptive framework for country-level analysis of health care financing arrangements," Health Policy, Elsevier, vol. 56(3), pages 171-204, June.
    18. Menon, Devidas & Stafinski, Tania & Martin, Douglas, 2007. "Priority-setting for healthcare: Who, how, and is it fair?," Health Policy, Elsevier, vol. 84(2-3), pages 220-233, December.
    19. Dena Ringold & Alaka Holla & Margaret Koziol & Santhosh Srinivasan, 2012. "Citizens and Service Delivery : Assessing the Use of Social Accountability Approaches in the Human Development Sectors," World Bank Publications - Books, The World Bank Group, number 2377, December.
    20. Peacock, Stuart & Mitton, Craig & Bate, Angela & McCoy, Bonnie & Donaldson, Cam, 2009. "Overcoming barriers to priority setting using interdisciplinary methods," Health Policy, Elsevier, vol. 92(2-3), pages 124-132, October.
    21. Salome A. Bukachi & Washington Onyango-Ouma & Jared Maaka Siso & Isaac K. Nyamongo & Joseph K. Mutai & Anna Karin Hurtig & Øystein Evjen Olsen & Jens Byskov, 2014. "Healthcare priority setting in Kenya: a gap analysis applying the accountability for reasonableness framework," International Journal of Health Planning and Management, Wiley Blackwell, vol. 29(4), pages 342-361, October.
    22. Dryzek, John S. & Niemeyer, Simon, 2008. "Discursive Representation," American Political Science Review, Cambridge University Press, vol. 102(4), pages 481-493, November.
    23. Yves Sintomer & Carsten Herzberg & Anja Röcke, 2008. "Participatory Budgeting in Europe: Potentials and Challenges," International Journal of Urban and Regional Research, Wiley Blackwell, vol. 32(1), pages 164-178, March.
    24. Dennis Waithaka & Benjamin Tsofa & Evelyn Kabia & Edwine Barasa, 2018. "Describing and evaluating healthcare priority setting practices at the county level in Kenya," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(3), pages 733-750, July.
    25. Prichard,Wilson & Custers,Anna Louise & Dom,Roel & Davenport,Stephen R. & Roscitt,Michael Anthony, 2019. "Innovations in Tax Compliance : Conceptual Framework," Policy Research Working Paper Series 9032, The World Bank.
    26. Woldemariam, Addis Tamire, 2016. "The administrator’s perspective," Health Economics, Policy and Law, Cambridge University Press, vol. 11(1), pages 79-83, January.
    27. World Bank, 2008. "Brazil - Toward a More Inclusive and Effective Participatory Budget in Porto Alegre : Volume 2. Annexes," World Bank Publications - Reports 6276, The World Bank Group.
    28. Rumbold, Benedict E. & Wilson, James, 2016. "Reasonable disagreement and the generally unacceptable: a philosophical analysis of Making Fair Choices," Health Economics, Policy and Law, Cambridge University Press, vol. 11(1), pages 91-96, January.
    29. Hysing, Erik, 2015. "Citizen participation or representative government – Building legitimacy for the Gothenburg congestion tax," Transport Policy, Elsevier, vol. 39(C), pages 1-8.
    30. Alex Y Lo & Kim S Alexander & Wendy Proctor & Anthony Ryan, 2013. "Reciprocity as Deliberative Capacity: Lessons from a Citizen's Deliberation on Carbon Pricing Mechanisms in Australia," Environment and Planning C, , vol. 31(3), pages 444-459, June.
    31. Daniels, Norman & Sabin, James E., 2002. "Setting Limits Fairly: Can we learn to share medical resources?," OUP Catalogue, Oxford University Press, number 9780195149364.
    32. Angela O’Hagan & Claire MacRae & Clementine Hill O’Connor & Paul Teedon, 2020. "Participatory budgeting, community engagement and impact on public services in Scotland," Public Money & Management, Taylor & Francis Journals, vol. 40(6), pages 446-456, July.
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