누구의 필요(Need)를 더 우선적으로 고려할 것인가?
Who Is the Worse Off in Health Care Resource Allocation?
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There is a broad consensus on the idea that multiple criteria should be considered in the reimburse- ment decision making. However, there are limited studies on what constitutes the value of medical technologies, and who should be given additional priority over others. For fair and ethically accept- able decision-making, we need to explore the public views on the priority setting criteria and their trade-offs. Recently, the National Institute for Health and Care Excellence published a consultation paper on the value-based assessment, where it recommended a valuation scheme which incorporates the burden of illness and a wider societal impact. Two criteria are in contrast to the current ‘end of life’ criteria, and there was a great deal of controversy over who is the worse-off. In Norway, the third Nor- wegian Committee in Priority Setting in the Health Sector published a comprehensive framework for priority setting. Among the three priority-setting criteria, the most controversial one was the health-loss criterion. Whether to consider only present and future health loss or lifetime health loss including past health was a point at issue.
Abstract
There is a broad consensus on the idea that multiple criteria should be considered in the reimburse- ment decision making. However, there are limited studies on what constitutes the value of medical technologies, and who should be given additional priority over others. For fair and ethically accept- able decision-making, we need to explore the public views on the priority setting criteria and their trade-offs. Recently, the National Institute for Health and Care Excellence published a consultation paper on the value-based assessment, where it recommended a valuation scheme which incorporates the burden of illness and a wider societal impact. Two criteria are in contrast to the current ‘end of life’ criteria, and there was a great deal of controversy over who is the worse-off. In Norway, the third Nor- wegian Committee in Priority Setting in the Health Sector published a comprehensive framework for priority setting. Among the three priority-setting criteria, the most controversial one was the health-loss criterion. Whether to consider only present and future health loss or lifetime health loss including past health was a point at issue.
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