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At least 19 recordsLinked to original sources
PubMed1991

The development of distributive justice orientations: contextual influences on children's resource allocations.

Previous research on the development of distributive justice decisions, by centering largely on situations in which rewards for work productivity are to be allocated, has shed little light on the child's developing ability to select the justice norm most appropriate to the situation. Children 5, 9, and 13 years of age were asked to allocate resources and judge the fairness of alternative decision rules in situations to which either equity, equality, or need norms were especially applicable. As predicted, young children were insensitive to contextual information, generally preferring to allocate resources equally, whereas older children tailored their decisions appropriately to the situation. The fact that developmental trends differed from situation to situation points to the importance of adopting a contextual perspective on the development of distributive justice orientations.

Adolescent↗
PubMed1991

A methodology for resource allocation in health care for South Africa. Part IV. Application of South African Health Resource Allocation formula.

The primary concern of this concluding article in a series is the application of the South African Health Resource Allocation (SAHRA) formula proposed in the previous article (SAMJ 1990; 77: 456-459). Target allocations based on this formula are compared with current budgets to estimate the extent of geographical maldistribution of health care resources. Under the present health service structure, the direction of redistribution of these resources should be from the provinces to 'homelands'. A number of refinements to the crude formula, such as the introduction of a more rational regionalisation policy and accounting for the teaching commitments of academic hospitals, are considered and their effects illustrated. Despite data deficiencies and the wide range of possible technical modifications to SAHRA, the concept of basing resource allocation decisions on an internationally applied formula is worthy of public debate.

Education, Medical↗
PubMed1986

Ethics and resource allocation: an economist's view.

This paper debates some of the issues involved in attempting to apply economic analysis to the health care sector when medical ethics plays such an important part in determining the allocation of resources in that sector. Two distinct ethical positions are highlighted as being fundamental to the understanding of resource allocation in this sector -- deontological and utilitarian theories of ethics. It is argued that medical ethics are often narrowly conceived in that there is a tendency for the individual, rather than society at large, to form the focal point of the production of the service "health care'. Thus medical ethics have been dominated by individualistic ethical coded which do not fully consider questions relating to resource allocation at a social level. It is further argued that the structure of the health care sector augments these "individualistic' ethics. It is also suggested that different actors in the health care sector address questions of resource allocation with respect to different time periods, and that this serves to further enhance the influence of "individualistic' ethical codes in this sector.

Cost-Benefit Analysis↗
PubMed1990

A methodology for resource allocation in health care for South Africa. Part III. A South African health resource allocation formula.

A formula to calculate the proportion of the public sector budget that should be allocated to various geographical regions of South Africa is described. The formula is broadly classified into curative and preventive components. Using data that are routinely available, indices of need are calculated for each of these components. It is concluded that resource allocation on a macro level should closely approximate regional population distribution if cross-border flow of patients and additional teaching-hospital expenditure are ignored.

Age Factors↗
PubMed1990

Resource allocation and the cost of quality.

The costs of producing quality medical care and the proper allocation of resources to assure quality are major contemporary concerns. Minimalists attempt to improve quality and lower costs through the application of the theory, "less is more." Bureaucracies make the same attempt through the denial of payments for "unnecessary" services. Governments and insurers try to "improve quality" by impeding the flow of new technology so that costs will be restricted (presumably allowing society better access to current care modalities). All impose regulations and requirements on medical practice. Each of these approaches is examined individually and substantial problems with their application in actual practice are illustrated. Genuine quality is not a cost or resource allocation problem. Quality is free.

Costs and Cost Analysis↗
PubMed1987

Measuring morbidity for resource allocation.

The RAWP (Resource Allocation Working Party) report used population weightings based on standardised mortality ratios (SMRs) as a proxy measure of differences in morbidity (and therefore in the need for health care resources) that existed between geographical areas after allowing for the age and sex structure of their populations. The adequacy of SMRs as a proxy for morbidity has aroused controversy, particularly from RAWP losers in London, and is one of the main themes of the National Health Service Management Board's current review of RAWP. Critics have argued, firstly, that the nature of the relation between morbidity and mortality is unknown; and, secondly, that SMRs are incomplete because they fail to take account of the effect of social deprivation on the need for health care. As a result several alternative proxies for morbidity based on social indicators have been proposed. One of their principal drawbacks is that their use is justified by their relation to measures of use of services known to be affected by the prevailing level of supply. Furthermore, the evidence suggests that mortality data actually correlate quite well with the available measures of both morbidity and social deprivation. But without access to comprehensive morbidity data the SMR debate is bound to remain inconclusive. As measures of health need, however, SMRs have the twin merits of being (a) independent of supply, and (b) more direct measures of health state than social indicators.

Health Resources↗
PubMed1991

Resource allocation in contemporary paediatrics: the case against high technology.

High technology has introduced a new dimension to medical treatment. There are inevitable social costs as well as benefits, and the allocation of resources to high technology, as opposed to other areas of health care, is a contentious issue. The current balance in health service funding between high technology and low technology is not appropriate. It is driven by the technological imperative and only offers solutions to a limited number of problems. There is a scarcity of health resources left to develop intersectoral responses and provide adequate funding for research into person-intensive interventions suitable for many problems. Arguments against allocating too many resources to high technology in paediatrics are examined in this paper.

Australia↗
PubMed1986

The ethics of resource allocation in critical care.

Increasingly, the ethics of resource allocation is becoming one of the most critical ethical problems faced by critical care decision makers; what is lacking is a framework for analyzing the ethics of decisions in resource allocation. This article examines the four ethical principles--patient-centered beneficence, autonomy, full beneficence, and justice--that can contribute to cost containment/resource allocation.

Beneficence↗
PubMed1990

Resource allocation: a plea for a touch of realism.

The problem of resource allocation in health has stimulated much thought and research, in attempts to provide objective, rational methods by which necessary choices can be made. One such method was proposed in a paper in this journal. The authors argued for a utilitarian approach, which they claimed to demonstrate was acceptable to society at large. This paper argues that the evidence supporting such a claim was flawed; such a utilitarian approach is not socially acceptable, and is therefore not relevant. Rather more relevant directions for research are discussed, based on the assertion that a degree of realism is essential when considering the problems of resource allocation.

England↗
PubMed1978

Subregional resource allocations in the National Health Service.

The Resource Allocation Working Party in its report Sharing Resources for Health in England proposes a formula for the identification of both regional and district financial targets (Department of Health and Social Security, 1976). In this paper it is argued that the national formula is not a valid instrument for the latter purpose. Furthermore, research into medical needs and outcomes will not be adequate to bring about real changes in resource distribution at local levels unless it is recognised that the health authorities can meet needs in different ways and that a change in resource management from institutional to service budgeting is required.

Catchment Area, Health↗
PubMed1988

Resource allocation in multifacility emergency medical service systems.

As instruments of public policy, Emergency Medical Service Systems must not only make effective use of the available resources but also ensure that those resources are shared equitably by the systems' facilities. This paper develops a multifacility EMS system resource allocation model that enables its user to evaluate the equitability of resource allocation schemes. Recognizing and objectively defining the relationships between the consumption of system resources and the provision of EMS System services, this model is appropriate for use in both prospective and retrospective EMS System resource allocation analyses.

Cost Allocation↗
PubMed2026

Coarse-grained resource allocation modeling for decoding and rewiring microbial metabolism.

Microbial metabolism is a complex, emergent system driven by the coordinated interplay of intricate and dynamic molecular processes. To elucidate cellular behavior and enable biotechnological applications, quantitative models that address the inherent complexity of metabolism have been developed from a resource allocation perspective. Here, we synthesize recent advances in coarse-grained resource allocation frameworks and their applications in understanding microbial physiology and guiding gene circuit design. These frameworks reveal global regulatory constraints and predict cellular adaptation to nutrient and environmental changes. In addition, they enable the quantification of metabolic costs, the dissection of circuit-host interactions, and the development of strategies for burden mitigation. Collectively, these modeling frameworks provide a powerful platform for uncovering quantitative principles of microbial growth and engineering robust synthetic biological systems.

coarse-grained modeling↗
PubMed1989

A methodology for resource allocation in health care for South Africa. Part I. Rationale and prerequisites.

A strategy for the equitable allocation of health care resources is needed in South Africa. The existing health administrative structures are obstacles to achieving this goal. An attempt is made to describe a framework in which the prerequisites for the equitable allocation of resources are a major restructuring of health services into a number of regional health authorities in a unified health service, and to establish a formula which is adapted from the RAWP (Resource Allocation Working Party) model used in the UK.

Health Care Rationing↗
PubMed1989

NHS resource allocation after the 1989 white paper: a critique of the research for the RAWP review.

The Government White Paper on the NHS, 'Working for Patients', abolished the Resource Allocation Working Party (RAWP) formula in name, but retained its general approach of ensuring geographical equity through funding health authorities by a system of weighted capitation. As a result, the longstanding debate about the appropriate need indicators to include in RAWP, which was tackled afresh in the recent NHS Management Board review of RAWP, will remain highly pertinent to NHS resource allocation in the 1990s. Yet, the research carried out for the RAWP review, on which its principal proposals for change to the need indicators were based, is inadequate for developing a new method of resource allocation after RAWP. The paper describes the research and sets out its main conceptual limitations and problems of method.

Catchment Area, Health↗
PubMed1987

Resource allocation decisions in health care: a role for quality of life assessments?

This paper discusses the relevance of quality of life measurement in clinical and epidemiological research to resource allocation decisions in health care. The discussion concentrates on economic evaluations, the form of health services research which most directly pertains to decisions about the allocation of resources, and the use of the quality-adjusted life-year in economic evaluation. Three key issues are addressed: whose assessments of quality of life are relevant and how should these be obtained; should one search for a generalizable quality of life measure; is it right to construct "league tables" of health care interventions in terms of cost per quality-adjusted life-year?

Decision Making↗
PubMed1988

The Veterans Administration's resource allocation system.

This article is designed to provide a description of the Veterans Administration's resource allocation system: an acute care, DRG case mix-based model; a long-term care, resource utilization group (RUG-II) model; and an ambulatory care, capitalization system. Nursing issues regarding resource allocation are discussed.

Acute Disease↗