Abstract
There are insufficient resources to meet all health care needs, and some form of prioritization is needed to ensure that these limited resources are used to their best effects. Resource allocation decisions need to account for the goals of a health care system, which can be numerous, diverse, and possibly in conflict with each other. Two such goals, central in many health care systems worldwide, are to provide health care both efficiently and equitably. Efficiency is usually considered in terms of the relationship between resource inputs and outputs, with the aim being to maximize “value” from the given resources. While the acceptability of including efficiency considerations in resource allocation decisions, the methods of doing so, and subsequent successes vary, seeking efficiency is a relatively noncontroversial aim for any health care system. Equity refers to the fair allocation of resources and involves subjective and moral judgement. It differs from equality, which refers to an objectively equal distribution of inputs or outcomes across a population. Definitions of equity are characterized by variations in underlying principles of access and need. While many governments consider equity alongside efficiency in policymaking, methods for doing so are not as explicit as those for efficiency considerations, and there is a belief that the two criteria of efficiency and equity are not fully compatible.
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References
Lancet Global Mental Health Group. Scale up services for mental disorders: a call for action. Lancet. 2007;370(9594):1241–52.
Patel A. The inevitable pursuit of efficiency. J Ment Health. 2013;22(2):89–92.
Knapp M. The economic perspective: framework and principles. In: Knapp M, editor. The economic evaluation of mental health care. Aldershot: Arena; 1995.
Palmer S, Torgerson D. Definitions of efficiency. BMJ. 1999;318(7191):1136.
Chisholm D, Evans DB. Improving health system efficiency as a means of moving towards universal coverage. World Health Report, Background Paper, Number 28. Geneva: World Health Organisation; 2010.
Sabik LM, Lie RK. Priority setting in health care: lessons from the experiences of eight countries. Int J Equity Health. 2008;7(4):1–13.
Cruz LN, da Silva Lima AF, Graeff-Martins AS, Maia CR, Ziegelmann PK, Polanczyk CA. Mental health economics: insights from Brazil. J Ment Health. 2013;22(2):111–21.
Mihalopoulos C, Carter R, Pirkis J, Vos T. Priority-setting for mental health services. J Ment Health. 2013;22(2):122–34.
Parkin D, Appleby J, Maynard A. Economics: the biggest fraud ever perpetrated on the world? Lancet. 2013;382:e11–5.
Horton R. What have economists ever done for global health? Lancet. 2014;383:1024.
Tengs TO. An evaluation of Oregon’s Medicaid rationing algorithms. Health Econ. 1996;5:171–81.
Papanicolas I, Smith PC, editors. Health system performance comparison. An agenda for policy, information and research. Berkshire: Open University Press McGraw-Hill Education; 2013.
Rawls J. Justice as fairness: political not metaphysical. Philos Public Aff. 1985;14:223–51.
Oliver A. Why care about health inequality? London: Office of Health Economics; 2001.
Oliver A, Mossialos E. Equity of access to health care: outlining the foundations for action. J Epidemiol Community Health. 2004;58:655–8.
World Health Organization. The world health report. Health systems financing: the path to universal coverage. Geneva: WHO; 2010.
Department of Health. Mental health act 1983: code of practice 2015. London: Department of Health; 2015.
Department of Health. Inequalities in health: report of an independent inquiry chaired by Sir Donald Acheson. London: The Stationery Office; 1998.
Sassi F, Le Grand J, Archand L. Equity versus efficiency: a dilemma for the NHS. BMJ. 2001;323:762–3.
Chisholm D, Stewart A. Economic and ethics in mental health care: traditions and trade-offs. J Ment Health Policy Econ. 1998;1:55–62.
Johannesson M. Should we aggregate relative or absolute changes in QALYs? Health Econ. 2001;10:573–7.
Franklin D. Calibrating QALYs to respect equality of persons. Utilitas; 2016. (FirstView Article June 2016, p. 1–23).
Sen A. Commodities and capabilities. Amsterdam: North-Holland; 1985.
Culyer AJ. Efficiency, equity and equality in health and health care. CHE Research Paper 120. York: University of York; 2015.
Woolhandler S, Campbell T, Himmelstein DU. Costs of health care administration in the United States and Canada. N Engl J Med. 2003;349:768–75.
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Patel, A. (2017). Equity and Efficiency. In: Razzouk, D. (eds) Mental Health Economics. Springer, Cham. https://doi.org/10.1007/978-3-319-55266-8_8
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DOI: https://doi.org/10.1007/978-3-319-55266-8_8
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