PubMed Health⌕ Search

Biomedical subjects

Paul Anand

Publications and source records attributed to Paul Anand.

5 recordsLinked to original sources
PubMed2005

Equity, capabilities and health.

This paper provides an introduction to a collection of articles concerning the relevance of Amartya Sen's work, the capability approach and related ethical claims, to health-care rationing.

Cluster Analysis↗
PubMed2005

The nature of procedural preferences for health-care rationing decisions.

Substantial debate on the appropriate foundations of economic evaluation in health-care has been conducted between welfarists and non-welfarists in the health economics literature. This has focussed on defining and measuring appropriate outcomes. However, there has been little discussion of the importance of procedures. This paper examines six dimensions of procedure in relation to health-care rationing which are drawn from existing literature and previous empirical investigation. A survey of the general public was used to test for preferences for each dimension of procedure. Results show that for each dimension the importance differed according to the level of decision-making (we tested decision-making at the level of the individual doctor, health authority and government). We identified three distinct clusters of respondents who can be broadly described as "proceduralists" (47%), "pluralists" (15%) and "anti-consequentialists" (38%). The paper concludes that consequentialism is insufficient to provide the conceptual framework that public decision-making in health requires, although this does not mean that consequences are unimportant.

Adult↗
PubMed2003

The integration of claims to health-care: a programming approach.

The paper contributes to the use of social choice and welfare theory in health economics by developing and applying the integration of claims framework to health-care rationing. Related to Sen's critique of neo-classical welfare economics, the integration of claims framework recognises three primitive sources of claim: consequences, deontology and procedures. A taxonomy is presented with the aid of which it is shown that social welfare functions reflecting these claims individually or together, can be specified. Some of the resulting social choice rules can be regarded as generalisations of health-maximisation and all have normative justifications, though the justifications may not be universally acceptable. The paper shows how non-linear programming can be used to operationalise such choice rules and illustrates their differential impacts on the optimal provision of health-care. Following discussion of relations to the capabilities framework and the context in which rationing occurs, the paper concludes that the integration of claims provides a viable framework for modelling health-care rationing that is technically rigorous, general and tractable, as well as being consistent with relevant moral considerations and citizen preferences.

Attitude to Health↗