Need-based resource allocation: different need indicators, different results?
Abstract Background A key policy objective in most publicly financed health care systems is to allocate resources according to need. Many jurisdictions implement this policy objective through need-based allocation models. To date, no gold standard exists for selecting need indicators. In the absence...
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ftdoajarticles:oai:doaj.org/article:8a962a19591e41498b67af3a95d5a331 2023-05-15T17:22:54+02:00 Need-based resource allocation: different need indicators, different results? Asada Yukiko Kephart George 2009-07-01T00:00:00Z https://doi.org/10.1186/1472-6963-9-122 https://doaj.org/article/8a962a19591e41498b67af3a95d5a331 EN eng BMC http://www.biomedcentral.com/1472-6963/9/122 https://doaj.org/toc/1472-6963 doi:10.1186/1472-6963-9-122 1472-6963 https://doaj.org/article/8a962a19591e41498b67af3a95d5a331 BMC Health Services Research, Vol 9, Iss 1, p 122 (2009) Public aspects of medicine RA1-1270 article 2009 ftdoajarticles https://doi.org/10.1186/1472-6963-9-122 2022-12-31T12:33:29Z Abstract Background A key policy objective in most publicly financed health care systems is to allocate resources according to need. Many jurisdictions implement this policy objective through need-based allocation models. To date, no gold standard exists for selecting need indicators. In the absence of a gold standard, sensitivity of the choice of need indicators is of concern. The primary objective of this study was to assess the consistency and plausibility of estimates of per capita relative need for health services across Canadian provinces based on different need indicators. Methods Using the 2000/2001 Canadian Community Health Survey, we estimated relative per capita need for general practitioner, specialist, and hospital services by province using two approaches that incorporated a different set of need indicators: (1) demographics (age and sex), and (2) demographics, socioeconomic status, and health status. For both approaches, we first fitted regression models to estimate standard utilization of each of three types of health services by indicators of need. We defined the standard as average levels of utilization by needs indicators in the national sample. Subsequently, we estimated expected per capita utilization of each type of health services in each province. We compared these estimates of per capita relative need with premature mortality in each province to check their face validity. Results Both approaches suggested that expected relative per capita need for three services vary across provinces. Different approaches, however, yielded different and inconsistent results. Moreover, provincial per capita relative need for the three health services did not always indicate the same direction of need suggested by premature mortality in each province. In particular, the two approaches suggested Newfoundland had less need than the Canadian average for all three services, but it had the highest premature mortality in Canada. Conclusion Substantial differences in need for health care may exist across Canadian ... Article in Journal/Newspaper Newfoundland Directory of Open Access Journals: DOAJ Articles Canada BMC Health Services Research 9 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Public aspects of medicine RA1-1270 |
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Public aspects of medicine RA1-1270 Asada Yukiko Kephart George Need-based resource allocation: different need indicators, different results? |
topic_facet |
Public aspects of medicine RA1-1270 |
description |
Abstract Background A key policy objective in most publicly financed health care systems is to allocate resources according to need. Many jurisdictions implement this policy objective through need-based allocation models. To date, no gold standard exists for selecting need indicators. In the absence of a gold standard, sensitivity of the choice of need indicators is of concern. The primary objective of this study was to assess the consistency and plausibility of estimates of per capita relative need for health services across Canadian provinces based on different need indicators. Methods Using the 2000/2001 Canadian Community Health Survey, we estimated relative per capita need for general practitioner, specialist, and hospital services by province using two approaches that incorporated a different set of need indicators: (1) demographics (age and sex), and (2) demographics, socioeconomic status, and health status. For both approaches, we first fitted regression models to estimate standard utilization of each of three types of health services by indicators of need. We defined the standard as average levels of utilization by needs indicators in the national sample. Subsequently, we estimated expected per capita utilization of each type of health services in each province. We compared these estimates of per capita relative need with premature mortality in each province to check their face validity. Results Both approaches suggested that expected relative per capita need for three services vary across provinces. Different approaches, however, yielded different and inconsistent results. Moreover, provincial per capita relative need for the three health services did not always indicate the same direction of need suggested by premature mortality in each province. In particular, the two approaches suggested Newfoundland had less need than the Canadian average for all three services, but it had the highest premature mortality in Canada. Conclusion Substantial differences in need for health care may exist across Canadian ... |
format |
Article in Journal/Newspaper |
author |
Asada Yukiko Kephart George |
author_facet |
Asada Yukiko Kephart George |
author_sort |
Asada Yukiko |
title |
Need-based resource allocation: different need indicators, different results? |
title_short |
Need-based resource allocation: different need indicators, different results? |
title_full |
Need-based resource allocation: different need indicators, different results? |
title_fullStr |
Need-based resource allocation: different need indicators, different results? |
title_full_unstemmed |
Need-based resource allocation: different need indicators, different results? |
title_sort |
need-based resource allocation: different need indicators, different results? |
publisher |
BMC |
publishDate |
2009 |
url |
https://doi.org/10.1186/1472-6963-9-122 https://doaj.org/article/8a962a19591e41498b67af3a95d5a331 |
geographic |
Canada |
geographic_facet |
Canada |
genre |
Newfoundland |
genre_facet |
Newfoundland |
op_source |
BMC Health Services Research, Vol 9, Iss 1, p 122 (2009) |
op_relation |
http://www.biomedcentral.com/1472-6963/9/122 https://doaj.org/toc/1472-6963 doi:10.1186/1472-6963-9-122 1472-6963 https://doaj.org/article/8a962a19591e41498b67af3a95d5a331 |
op_doi |
https://doi.org/10.1186/1472-6963-9-122 |
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BMC Health Services Research |
container_volume |
9 |
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1 |
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1766109808876847104 |