Priority setting in health care: Lessons from the experiences of eight countries

Sabik, Lindsay M; Lie, Reidar K

doi:10.1186/1475-9276-7-4

Cited by 312Health Systems, Economic Evaluations, Quality of LifeHealthcare Systems and ReformsHealthcare Systems and Practices

Priority setting in health care: Lessons from the experiences of eight countries

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Sabik, Lindsay M, Lie, Reidar K·2008·International Journal for Equity in Health

DOI 10.1186/1475-9276-7-4PMC PMC2248188

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Abstract

All health care systems face problems of justice and efficiency related to setting priorities for allocating a limited pool of resources to a population. Because many of the central issues are the same in all systems, the United States and other countries can learn from the successes and failures of countries that have explicitly addressed the question of health care priorities.We review explicit priority setting efforts in Norway, Sweden, Israel, the Netherlands, Denmark, New Zealand, the United Kingdom and the state of Oregon in the US. The approaches used can be divided into those centered on outlining principles versus those that define practices. In order to establish the main lessons from their experiences we consider (1) the process each country used, (2) criteria to judge the success of these efforts, (3) which approaches seem to have met these criteria, and (4) using their successes and failures as a guide, how to proceed in setting priorities. We demonstrate that there is little evidence that establishment of a values framework for priority setting has had any effect on health policy, nor is there evidence that priority setting exercises have led to the envisaged ideal of an open and participatory public involvement in decision making.

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A wide range of approaches is taken and guidelines for priority-setting vary across different countries, illustrating that priority-setting is complex.
“A wide range of approaches is taken and guidelines vary across different countries [16], illustrating that priority-setting is complex”
From Measuring the Effect of the Early assessment Team (MEET) for patients referred to outpatient mental health care: a study protocol for a randomised controlled trial (2024) · cites this paper as [16]

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Health Care Systems: Efficiency and InstitutionsPreprint
Joumard, I., Andre, C., & Nicq, C. (2010) · SSRN Electronic Journal · doi:10.2139/ssrn.1616546 · Cited by 243 · see citing works
‘You’re on the waiting list’: An interpretive phenomenological analysis of young adults’ experiences of waiting lists within mental health services in the UK
Punton, G., Dodd, A. L., & McNeill, A. (2022) · PLOS ONE · doi:10.1371/journal.pone.0265542 · Cited by 167 · see citing works
“As mental health services tend to prioritise more serious cases [69], by neglecting to physically care for herself, Amy was aiming at being seen as a priority.”
Background
Priority setting in health: origins, description and application of the Australian Assessing Cost–Effectiveness initiative
Carter, R., Vos, T., Moodie, M., Haby, M. M., Magnus, A., & Mihalopoulos, C. (2008) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/14737167.8.6.593 · Cited by 162 · see citing works
The Economic Analysis of Prevention in Mental Health Programs
Mihalopoulos, C., Vos, T., Pirkis, J., & Carter, R. (2011) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032210-104601 · Cited by 159 · see citing works
Health Care Systems
Joumard, I., André, C., & Nicq, C. (2010) · OECD Economics Department working papers · doi:10.1787/5kmfp51f5f9t-en · Cited by 133 · see citing works
Looking back and moving forward: On the application of proportional shortfall in healthcare priority setting in the Netherlands
Reckers‐Droog, V., van Exel, J. N. A., & Brouwer, W. B. F. (2018) · Health Policy · doi:10.1016/j.healthpol.2018.04.001 · Cited by 125 · see citing works
A Systematic Review of Stated Preference Studies Reporting Public Preferences for Healthcare Priority Setting
Whitty, J. A., Lancsar, E., Rixon, K., Golenko, X., & Ratcliffe, J. (2014) · Patient · doi:10.1007/s40271-014-0063-2 · Cited by 121 · see citing works
“1 Background Priority setting in healthcare is inevitable [1, 2].”
Background
Priority-setting and rationing in healthcare: Evidence from the English experience
Robinson, S., Williams, I., Dickinson, H., Freeman, T., & Rumbold, B. (2012) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.09.014 · Cited by 112 · see citing works
“Public sector service reductions are apparent within many countries, and as tough decisions on resource allocation are required to be made it is perhaps unsurprising that explicit priority-setting has gained political salience (Sabik and Lie, 2008).”
BackgroundMethodInfluential
Health care reform in Chile
Gabriel Bastías, S., Tomás Pantoja, C., Leisewitz, T., & Zárate, V. (2008) · Canadian Medical Association Journal · doi:10.1503/cmaj.071843 · Cited by 104 · see citing works
“A number of initiatives developed to introduce scientific evidence into health policy could be used to tackle these challenges.(20,21) Such initiatives would require a much closer collaboration between policymakers and researchers with a common aim of improving the general health of the Chilean population.”
Background
Health technology prioritization: Which criteria for prioritizing new technologies and what are their relative weights?
Golan, O. G., Hansen, P., Kaplan, G., & Tal, O. (2010) · Health Policy · doi:10.1016/j.healthpol.2010.10.012 · Cited by 99 · see citing works
Patient and Citizen Participation in Health: The Need for Improved Ethical Support
Williamson, L. (2014) · The American Journal of Bioethics · doi:10.1080/15265161.2014.900139 · Cited by 91 · see citing works
Severity as a Priority Setting Criterion: Setting a Challenging Research Agenda
Barra, M., Broqvist, M., Gustavsson, E., Henriksson, M., Juth, N., Sandman, L., & Solberg, C. T. (2019) · Health Care Analysis · doi:10.1007/s10728-019-00371-z · Cited by 89 · see citing works
What's In, What's Out: Designing Benefits for Universal Health Coverage
Glassman, A. L., Giedión, Ú., & Smith, P. (2017) · Cited by 87 · see citing works
Decentralized health care priority-setting in Tanzania: Evaluating against the accountability for reasonableness framework
Maluka, S. O., Kamuzora, P., Sebastiån, M. S., Byskov, J., Olsen, Ø. E., Shayo, E. H., Ndawi, B., & Hurtig, A. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.04.035 · Cited by 85 · see citing works
“However, the search for effective methods of priority-setting in health care has shown that there are no simple or technical solutions (Sabik & Lie, 2008).”
Background
What Are the Consequences of Waiting for Health Care in the Veteran Population?
Pizer, S. D., & Prentice, J. C. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1819-1 · Cited by 81 · see citing works
Successful Priority Setting in Low and Middle Income Countries: A Framework for Evaluation
Kapiriri, L., & Martin, D. K. (2009) · Health Care Analysis · doi:10.1007/s10728-009-0115-2 · Cited by 73 · see citing works
“In a recent publication, evaluating priority setting in eight countries, Sabik and Lie [ 28 ] proposed three criteria to judge priority setting efforts namely, public input, appropriate principles, and effect on policy.”
Background
Maximisation in extra-welfarism: A critique of the current position in health economics
Coast, J. (2009) · Social Science & Medicine · doi:10.1016/j.socscimed.2009.06.026 · Cited by 69 · see citing works
Resource Allocation and Priority Setting in Health Care: A Multi‐criteria Decision Analysis Problem of Value?
Angelis, A., Kanavos, P. G., & Montibeller, G. (2016) · Global Policy · doi:10.1111/1758-5899.12387 · Cited by 67 · see citing works
Revision of the Ethiopian Essential Health Service Package: An Explication of the Process and Methods Used
Eregata, G. T., Hailu, A., Geletu, Z. A., Memirie, S. T., Johansson, K. A., Stenberg, K., Bertram, M., Aman, A., & Norheim, O. F. (2020) · Health Systems & Reform · doi:10.1080/23288604.2020.1829313 · Cited by 65 · see citing works
“52 As in the Ethiopian case, the revision process in Chile, Thailand and Malawi was participatory.”
Background
Strengthening fairness, transparency and accountability in health care priority setting at district level in Tanzania
Maluka, S. O. (2011) · Global Health Action · doi:10.3402/gha.v4i0.7829 · Cited by 64 · see citing works
Equity Weights for Priority Setting in Healthcare: Severity, Age, or Both?
Reckers‐Droog, V., van Exel, J. N. A., & Brouwer, W. B. F. (2019) · Value in Health · doi:10.1016/j.jval.2019.07.012 · Cited by 63 · see citing works
“Allocation decisions can be guided by both efficiency and equity principles, and hence be informed by the costeffectiveness of health technologies and equity considerations associated with, for example, patient and disease characteristics.(1-6) Although it has been advocated to explicitly and transparently incorporate…”
Background
Cost and cost-effectiveness of childhood cancer treatment in low-income and middle-income countries: a systematic review
Fung, A., Horton, S., Zabih, V., Denburg, A., & Gupta, S. (2019) · BMJ Global Health · doi:10.1136/bmjgh-2019-001825 · Cited by 63 · see citing works
“63 At times, social, cultural and political sentiments may prevail over cost-effectiveness or other purely economic factors in determining prioritisation of healthcare investments.”
Health sector priority setting at meso-level in lower and middle income countries: Lessons learned, available options and suggested steps
Hipgrave, D. B., Alderman, K. B., Anderson, I., & Jimenez‐Soto, E. (2013) · Social Science & Medicine · doi:10.1016/j.socscimed.2013.11.056 · Cited by 58 · see citing works
“…values (clarity of process to limit the influence of contextual issues like public perception and political influence), substantive values (the priority-setting criteria and principles to be followed), and terminal values (the goals of the process) (Kenny & Joffres, 2008; Sabik & Lie, 2008).”
Background
Delegation and Institutional Design in Health‐Care Rationing
Landwehr, C., & Böhm, K. (2011) · Governance · doi:10.1111/j.1468-0491.2011.01542.x · Cited by 57 · see citing works
Citizen Participation in Patient Prioritization Policy Decisions: An Empirical and Experimental Study on Patients' Characteristics
Diederich, A., Swait́, J., & Wirsik, N. (2012) · PLoS ONE · doi:10.1371/journal.pone.0036824 · Cited by 56 · see citing works
“While specifics differ from country to country, controlling or reducing the cost of health care delivery takes a central role in the debate about reform in all of these places [2,3].”
Background
Health Care Expenditure in the OECD Countries: Efficiency and RegulationPreprint
de Cos, P. H., & Moral‐Benito, E. (2011) · SSRN Electronic Journal · doi:10.2139/ssrn.1974882 · Cited by 54 · see citing works
Innovation as a value in healthcare priority-setting: the UK experience
Charlton, V., & Rid, A. (2019) · Social Justice Research · doi:10.1007/s11211-019-00333-9 · Cited by 49 · see citing works
Being Healthy, Being Sick, Being Responsible: Attitudes towards Responsibility for Health in a Public Healthcare System
Traina, G., Martinussen, P. E., & Feiring, E. (2019) · Public Health Ethics · doi:10.1093/phe/phz009 · Cited by 48 · see citing works
“Some countries have proposed policies that consider personal responsibility as a criterion for healthcare coverage and access (Laverty and Harris, 2018), applying diversified co-payments and waiting lists or excluding certain treatments from the basket of public healthcare services when the disease is ‘self-inflicted’…”
Background
Which health technologies should be funded? A prioritization framework based explicitly on value for money
Golan, O. G., & Hansen, P. (2012) · Israel Journal of Health Policy Research · doi:10.1186/2045-4015-1-44 · Cited by 45 · see citing works
“This requirement, or, conversely, the absence of such guidance for decision-makers internationally, has been pointed out many times by researchers [10,12-16].”
Background
Social values and health systems in health policy and systems research: a mixed-method systematic review and evidence map
Whyle, E. B., & Olivier, J. (2020) · Health Policy and Planning · doi:10.1093/heapol/czaa038 · Cited by 44 · see citing works
Priority setting in primary health care - dilemmas and opportunities: a focus group study
Arvidsson, E., André, M., Borgqúist, L., & Carlsson, P. (2010) · BMC Family Practice · doi:10.1186/1471-2296-11-71 · Cited by 43 · see citing works
“Several countries with publicly financed health care systems have formulated ethical principles and criteria for priority setting in health care [1,5,7,8].”
Background
Assessing the context of health care utilization in Ecuador: A spatial and multilevel analysis
López‐Cevallos, D. F., & Chi, C. (2010) · BMC Health Services Research · doi:10.1186/1472-6963-10-64 · Cited by 41 · see citing works
“Recent research suggests the need to balance an expert-led process and one “that emphasizes public involvement in decision making” [44].”
Background
How have systematic priority setting approaches influenced policy making? A synthesis of the current literature
Kapiriri, L., & Razavi, D. (2017) · Health Policy · doi:10.1016/j.healthpol.2017.07.003 · Cited by 41 · see citing works
Priority setting in health care: trends and models from Scandinavian experiences
Hofmann, B. (2012) · Medicine Health Care and Philosophy · doi:10.1007/s11019-012-9414-8 · Cited by 39 · see citing works
Lifetime QALY prioritarianism in priority setting: quantification of the inherent trade-off
Ottersen, T., Mæstad, O., & Norheim, O. F. (2014) · Cost Effectiveness and Resource Allocation · doi:10.1186/1478-7547-12-2 · Cited by 37 · see citing works
““severity,” or “urgency”—enjoys wide support in theory [7,9,13,14], public opinion [11,15], and health policy [3,16].”
Background
Prioritizing Clinical Preventive Services: A Review and Framework with Implications for Community Preventive Services
Maciosek, M. V., Coffield, A. B., Edwards, N. M., Flottemesch, T. J., & Solberg, L. I. (2009) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.031308.100253 · Cited by 37 · see citing works
Stated and Revealed Preferences for Funding New High-Cost Cancer Drugs: A Critical Review of the Evidence from Patients, the Public and Payers
Macleod, T. E., Harris, A., & Mahal, A. S. (2015) · Patient · doi:10.1007/s40271-015-0139-7 · Cited by 37 · see citing works
“Our findings are consistent with the empirical literature of payer funding decisions for pharmaceuticals in general; several countries (Australia, Denmark, France, Norway, the Netherlands, UK) prioritize cancer drug treatments on the basis of disease severity [6, 60, 61], and the related term ‘life-threatening’ is als…”
BackgroundResult
The Desirability of Being Open About Health Care Rationing Decisions: Findings from a Qualitative Study of Patients and Clinical Professionals
Owen‐Smith, A., Coast, J., & Donovan, J. (2009) · Journal of Health Services Research & Policy · doi:10.1258/jhsrp.2009.009045 · Cited by 37 · see citing works
Multi-criteria Decision Analysis Software in Healthcare Priority Setting: A Systematic Review
Moreno-Calderón, A., Tong, T., & Thokala, P. (2019) · PharmacoEconomics · doi:10.1007/s40273-019-00863-9 · Cited by 36 · see citing works
Mental health service system improvement: Translating evidence into policy
Whiteford, H., Harris, M., & Diminic, S. (2013) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867413494867 · Cited by 35 · see citing works
“, 2007), cost-effectiveness alone rarely influences priority setting (Sabik and Lie, 2008), and integrative interventions have not been able to compete when funding decisions are made within service silos (e.”
Background
Gatekeeper family doctors operating a decentralized referral prioritization system: Uncovering improvements in system resilience through a grounded-based approach
Arcuri, R., Bulhões, B., Jatobá, A., Bellas, H. C., Koster, I., d’Avila, A. L., Vidal, M. C., Burns, C. M., & de Carvalho, P. V. R. (2019) · Safety Science · doi:10.1016/j.ssci.2019.08.023 · Cited by 35 · see citing works
Scoping literature review on the basic health benefit package and its determinant criteria
Hayati, R., Bastani, P., Kabir, M. J., Kavosi, Z., & Sobhani, G. (2018) · Globalization and Health · doi:10.1186/s12992-018-0345-x · Cited by 34 · see citing works
“The National Institute for Health and Care Excellence (NICE) in England has clearly defined the “costs of intervention” criteria in development of guidelines and evaluation of technologies [31].”
Background
Setting Health-Care Priorities
Tännsjö, T. (2019) · doi:10.1093/oso/9780190946883.001.0001 · Cited by 34 · see citing works
Applying priority-setting frameworks: A review of public and vulnerable populations’ participation in health-system priority setting
Razavi, D., Kapiriri, L., Wilson, M. G., & Abelson, J. (2019) · Health Policy · doi:10.1016/j.healthpol.2019.12.005 · Cited by 33 · see citing works
Analysis of the Cost-Effectiveness of Liquid Biopsy to Determine Treatment Change in Patients with Her2-Positive Advanced Breast Cancer in Colombia
Calderón, D. C. S., Pedraza, A. M., Urrego, C., Mejía-Mejía, A., Montealegre, A. L., & Perdomo, S. P. (2020) · ClinicoEconomics and Outcomes Research · doi:10.2147/ceor.s220726 · Cited by 33 · see citing works
Structures and processes for priority-setting by health-care funders: a national survey of primary care trusts in England
Robinson, S., Dickinson, H., Freeman, T., Rumbold, B. E., & Williams, I. (2012) · Health Services Management Research · doi:10.1258/hsmr.2012.012007 · Cited by 32 · see citing works
Priority-setting for mental health services
Mihalopoulos, C., Carter, R., Pirkis, J., & Vos, T. (2013) · Journal of Mental Health · doi:10.3109/09638237.2012.745189 · Cited by 32 · see citing works
Stakeholder involvement in expensive drug recommendation decisions: An international perspective
Rosenberg-Yunger, Z. R. S., Thorsteinsdóttir, H., Daar, A. S., & Martin, D. K. (2012) · Health Policy · doi:10.1016/j.healthpol.2011.12.002 · Cited by 32 · see citing works
High performance in healthcare priority setting and resource allocation: A literature- and case study-based framework in the Canadian context
Smith, N., Mitton, C., Hall, W., Bryan, S., Donaldson, C., Peacock, S. J., Gibson, J., & Urquhart, B. S. (2016) · Social Science & Medicine · doi:10.1016/j.socscimed.2016.06.027 · Cited by 32 · see citing works
“Real discussions that actually would lead to them having input into things like budget allocation” (C2, senior exec). made” (Sabik and Lie, 2008).”
Background
Telessaúde como eixo organizacional dos sistemas universais de saúde do século XXI
Harzheim, E., Chueiri, P. S., Umpierre, R. N., Gonçalves, M. R., Siqueira, A. C. D. S., D’Ávila, O. P., Bastos, C. G. M., Katz, N., Moro, R. G. D., Telles, L. F., et al. (2019) · Revista Brasileira de Medicina de Família e Comunidade · doi:10.5712/rbmfc14(41)1881 · Cited by 40 · see citing works
Research priority setting for health policy and health systems strengthening in Nigeria: the policymakers’ and stakeholders’ perspective and involvement
Uneke, C. J., Ezeoha, A. E., Ndukwe, C. D., Oyibo, P. G., Onwe, F., & Aulakh, B. K. (2013) · Pan African Medical Journal · doi:10.11604/pamj.2013.16.10.2318 · Cited by 32 · see citing works
“According to Sabik and Lie [1], the scarcity of resources raises questions of justice and efficiency: how should limited health care resources be allocated? what health services should be publicly funded? How should indications for particular interventions be defined? Priority setting can provide answers to some of th…”
Background
The Relevance of Personal Characteristics in Allocating Health Care Resources—Controversial Preferences of Laypersons with Different Educational Backgrounds
Winkelhage, J., & Diederich, A. (2012) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph9010223 · Cited by 32 · see citing works
“Priority setting in resource allocation seems inevitable [2].”
Efficiency or equity: value judgments in coverage decisions in Thailand
Tantivess, S., Velasco, R. P., Yothasamut, J., Mohara, A., Limprayoonyong, H., & Teerawattananon, Y. (2012) · Journal of Health Organization and Management · doi:10.1108/14777261211238972 · Cited by 31 · see citing works
Who Shall Not Be Treated: Public Attitudes on Setting Health Care Priorities by Person-Based Criteria in 28 Nations
Rogge, J., & Kittel, B. (2016) · PLoS ONE · doi:10.1371/journal.pone.0157018 · Cited by 31 · see citing works
A review of appropriate indicators for need-based financial resource allocation in health systems
Radinmanesh, M., Azar, F. E., Hashjin, A. A., Najafi, B., & Majdzadeh, R. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06522-0 · Cited by 30 · see citing works
Healthcare priority setting in Kenya: a gap analysis applying the accountability for reasonableness framework
Bukachi, S. A., Onyango‐Ouma, W., Siso, J. M., Nyamongo, I. K., Mutai, J. K., Hurtig, A., Olsen, Ø. E., & Byskov, J. (2013) · The International Journal of Health Planning and Management · doi:10.1002/hpm.2197 · Cited by 30 · see citing works
Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey
Smith, N., Mitton, C., Bryan, S., Davidson, A., Urquhart, B. S., Gibson, J. L., Peacock, S. J., & Donaldson, C. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-247 · Cited by 30 · see citing works
“note, “only a few studies have presented ideas for evaluating the success of priority setting” [46]; see also [43,47-49].”
Background
Who should receive treatment? An empirical enquiry into the relationship between societal views and preferences concerning healthcare priority setting
Reckers‐Droog, V., van Exel, J. N. A., & Brouwer, W. B. F. (2018) · PLoS ONE · doi:10.1371/journal.pone.0198761 · Cited by 29 · see citing works
Social value judgments in healthcare: a philosophical critique
Biron, L., Rumbold, B. E., & Faden, R. (2012) · Journal of Health Organization and Management · doi:10.1108/14777261211238963 · Cited by 28 · see citing works
Priority setting and implementation in a centralized health system: a case study of Kerman province in Iran
Khayatzadeh‐Mahani, A., Fotaki, M., & Harvey, G. (2012) · Health Policy and Planning · doi:10.1093/heapol/czs082 · Cited by 28 · see citing works
“…describing priority setting processes at the macro (national) level in many health systems, this mostly focuses on developed countries (for example, Ham 1997; Busse 1999; Calltorp 1999; Rissanen and Hakkinen 1999; Stepan and Sommersguter-Reichmann 1999; Pedersen et al. 2005; Sabik and Lie 2008).”
Background
Prioridades de Investigación en Salud en Colombia: Perspectiva de los Investigadores
C, C. A. A., de la Hoz, F., Mojica, M. J., Castañeda, J. C. E., Robledo-Martínez, R., Cifuentes, M. P., & Alvis‐Guzmán, N. (2009) · Revista de Salud Pública · doi:10.1590/s0124-00642009000200014 · Cited by 27 · see citing works
Guidelines, policies, and barriers to kidney care: findings from a global survey
Lunney, M., Alrukhaimi, M. N., Ashuntantang, G., Bello, A. K., Bellorín-Font, E., Gharbi, M. B., Jha, V., Johnson, D. W., Kalantar‐Zadeh, K., Kazancıoğlu, R., et al. (2018) · Kidney International Supplements · doi:10.1016/j.kisu.2017.10.007 · Cited by 27 · see citing works
“3 (10) 8 (31) 8 (35) 7 (30) 8 (50) 6 (38) 9 (60) 8 (57) 2 (13) 10 (63) 8 (50) 10 (63) 3 (23) 5 (38) 8 (73) 5 (50) 3 (50) 2 (33) 4 (67) 3 (50) 0 (0) 1 (50) 1 (50) 0 (0) 0 (0) 4 (67) 4 (67) 1 (17) 2 (15) 7 (58) 7 (58) 5 (45) 2 (40) 1 (33) 3 (75) 3 (75) 4 (44) 4 (44) 5 (56) 5 (56)”
In a democracy, what should a healthcare system do? A dilemma for public policymakers
Oswald, M. (2013) · Politics Philosophy & Economics · doi:10.1177/1470594x13497670 · Cited by 25 · see citing works
“Other bioethicists have supported, and suggested enhancements to, A4R, and the approach (or elements of it) has been tested in several democracies (Daniels and Sabin, 2007: 149–229; Gibson et al., 2005; Sabik and Lie, 2008: 10–11; Syrett, 2008).”
Background
Sustainability in Health care by Allocating Resources Effectively (SHARE) 6: investigating methods to identify, prioritise, implement and evaluate disinvestment projects in a local healthcare setting
Harris, C., Allen, K., Brooke, V., Dyer, T., Waller, C., King, R., Ramsey, W., & Mortimer, D. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2269-1 · Cited by 25 · see citing works
Priority setting in health care: from arbitrariness to societal values
Batifoulier, P., Braddock, L., & Latsis, J. (2012) · Journal of Institutional Economics · doi:10.1017/s174413741200015x · Cited by 25 · see citing works
Eliciting societal preferences of reimbursement decision criteria for anti cancer drugs in South Korea
Kwon, S., Park, S., Byun, J.-H., & Lee, E. (2016) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1080/14737167.2017.1277144 · Cited by 25 · see citing works
Priority setting in practice: Participants opinions on vertical and horizontal priority setting for reallocation
Waldau, S., Lindholm, L. H., & Wiechel, A. H. (2010) · Health Policy · doi:10.1016/j.healthpol.2010.02.007 · Cited by 24 · see citing works
Setting Priorities For Comparative Effectiveness Research: From Assessing Public Health Benefits To Being Open With The Public
Dubois, R. W., & Graff, J. S. (2011) · Health Affairs · doi:10.1377/hlthaff.2011.0136 · Cited by 24 · see citing works
Commissioning [Integrated] Care in England: An Analysis of the Current Decision Context
Góngora, P., Głogowska, M., Fitzpatrick, R. M., Perera, R., & Tsiachristas, A. (2022) · International Journal of Integrated Care · doi:10.5334/ijic.6693 · Cited by 23 · see citing works
Are patients receiving enough information about healthcare rationing? A qualitative study: Table 1
Owen‐Smith, A., Coast, J., & Donovan, J. (2010) · Journal of Medical Ethics · doi:10.1136/jme.2009.033241 · Cited by 23 · see citing works
“and policymakers around the world have responded to this by introducing policies to set priorities more explicitly.”
Background
Barriers and facilitators to implementing priority setting and resource allocation tools in hospital decisions: A systematic review
Ahumada‐Canale, A., Jeet, V., Bilgrami, A., Seil, E., Gu, Y., & Cutler, H. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.115790 · Cited by 22 · see citing works
Equity, justice, and social values in priority setting: a qualitative study of resource allocation criteria for global donor organizations working in low-income countries
Kapiriri, L., & Razavi, D. (2022) · International Journal for Equity in Health · doi:10.1186/s12939-021-01565-5 · Cited by 21 · see citing works
What values do the public want their health care systems to use in evaluating technologies?
Buxton, M. J., & Chambers, J. D. (2011) · The European Journal of Health Economics · doi:10.1007/s10198-011-0320-4 · Cited by 21 · see citing works
The Role of Ethics Committees and Ethics Consultation in Allocation Decisions
Strech, D., Hurst, S., & Danis, M. (2010) · Medical Care · doi:10.1097/mlr.0b013e3181e577fb · Cited by 21 · see citing works
“There is relatively broad consensus that the extent of the benefit and of the cost-effectiveness of an available intervention, the severity of the illness, and the availability of an alternative intervention should play a central role in the ethical consideration of rationing decisions.(1,24,29) There is a similarly b…”
Background
Self‐responsibility, rationing and treatment decision making – managing moral narratives alongside fiscal reality in the obesity surgery clinic
Owen‐Smith, A., Coast, J., & Donovan, J. (2018) · Health Expectations · doi:10.1111/hex.12651 · Cited by 21 · see citing works
Priority setting in Indigenous health: assessing priority setting process and criteria that should guide the health system to improve Indigenous Australian health
Otim, M. E., Kelaher, M., Anderson, I. P. S., & Doran, C. M. (2014) · International Journal for Equity in Health · doi:10.1186/1475-9276-13-45 · Cited by 21 · see citing works
“An assessment of explicit priority setting attempted in several countries such as the United Kingdom, New Zealand and Sweden by Sabik and Lie yielded mixed results [28].”
Background
What Factors Do Allied Health Take Into Account When Making Resource Allocation Decisions?
Lane, H., Sturgess, T., Philip, K., Markham, D., Martin, J., Walsh, J., Hubbard, W., & Haines, T. P. (2017) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2017.105 · Cited by 20 · see citing works
The Humanistic and Economic Burden of Juvenile Idiopathic Arthritis in the era of Biologic Medication
Gidman, W. K., Meacock, R., & Symmons, D. P. M. (2015) · Current Rheumatology Reports · doi:10.1007/s11926-015-0508-1 · Cited by 19 · see citing works
“In a climate of finite healthcare budgets and scarce resources, decision-makers are increasingly using economic evaluations to guide resource allocation decisions [9, 14, 27].”
Background
Setting priorities in primary health care - on whose conditions? A questionnaire study
Arvidsson, E., André, M., Borgqúist, L., Andersson, D., & Carlsson, P. (2012) · BMC Family Practice · doi:10.1186/1471-2296-13-114 · Cited by 19 · see citing works
“Several countries with publicly financed health care systems use similar criteria [16,17].”
Background
Economic considerations on the usage of biologics in the allergy clinic
Azzano, P., Dufresne, É., Poder, T. G., & Bégin, P. (2020) · Allergy · doi:10.1111/all.14494 · Cited by 18 · see citing works
Health-care needs and shared decision-making in priority-setting
Gustavsson, E., & Sandman, L. (2014) · Medicine Health Care and Philosophy · doi:10.1007/s11019-014-9568-7 · Cited by 18 · see citing works
Indeterminacy and the principle of need
Herlitz, A. (2016) · Metamedicine · doi:10.1007/s11017-016-9393-5 · Cited by 18 · see citing works
Needs and cost-effectiveness in health care priority setting
Gustavsson, E., & Tinghög, G. (2020) · Health and Technology · doi:10.1007/s12553-020-00424-7 · Cited by 18 · see citing works
Comparative analysis of decision maker preferences for equity/efficiency attributes in reimbursement decisions in three European countries
Baji, P., García‐Goñi, M., Gulàcsi, L., Mentzakis, E., & Paolucci, F. (2015) · The European Journal of Health Economics · doi:10.1007/s10198-015-0721-x · Cited by 18 · see citing works
“Attributes, such as the potential number of beneficiaries, the severity of disease, the individual health benefit of the intervention are explicitly specified in some reimbursement regulations or recommendations [2,3].”
Background
The health systems' priority setting criteria for selecting health technologies: A systematic review of the current evidence.
Mobinizadeh, M., Raeissi, P., Nasiripour, A. A., Olyaeemanesh, A., & Tabibi, S. J. (2016) · PubMed Central · Cited by 18 · see citing works
Horizontal equity and mental health care: a study of priority ratings by clinicians and teams at outpatient clinics
Holman, P. A., Ruud, T., & Grepperud, S. (2012) · BMC Health Services Research · doi:10.1186/1472-6963-12-162 · Cited by 17 · see citing works
“Priority-setting is a complex and difficult challenge faced by decision-makers at all levels of a health care system, and a wide range of approaches and priority-setting guidelines are observed across various countries [2].”
Health inequality and governance in Scotland since 2007
Fox, D. M. (2013) · Public Health · doi:10.1016/j.puhe.2013.04.019 · Cited by 17 · see citing works
“Still others conduct cross-national comparisons of priority-setting processes or of spending to address various determinants of health, again without explicit attention to the effects of governance on policy.(15) This article, in contrast, seeks to answer questions about the governance of recent health policy in Scotl…”
Operationalization of Utilitarian and Egalitarian Objectives for Optimal Allocation of Health Care Resources
Hynninen, Y., Vilkkumaa, E., & Salo, A. A. (2020) · Decision Sciences · doi:10.1111/deci.12448 · Cited by 17 · see citing works
“…and programs is to reduce health inequalities, which has inspired much research on the equitable allocation of resources and the assessment of populationlevel equity considerations (see, e.g., Eddy, 1991; Emanuel, 2000; Beauchamp & Childress, 2001; Sabik & Lie, 2008; Hooker & Williams, 2012).”
Background
Using evaluation theory in priority setting and resource allocation
Smith, N., Mitton, C., Cornelissen, E., Gibson, J., & Peacock, S. J. (2012) · Journal of Health Organization and Management · doi:10.1108/14777261211256963 · Cited by 17 · see citing works
What explains ‘generosity’ in the public financing of high-tech drugs? An empirical investigation of 25 OECD countries and 11 controversial drugs
Böhm, K., Landwehr, C., & Steiner, N. D. (2014) · Journal of European Social Policy · doi:10.1177/0958928713511280 · Cited by 16 · see citing works
“A major European project has analyzed the content of health baskets in numerous countries (Schulenburg and Blanke 2004), and several studies have compared decision-making processes in smaller sets of countries (e.g. Ham and Robert 2003; Sabik and Lie 2008; Landwehr and Böhm 2011).”
Background
Understanding what matters: An exploratory study to investigate the views of the general public for priority setting criteria in health care
Ratcliffe, J., Lancsar, E., WALKER, R. B., & Gu, Y. (2017) · Health Policy · doi:10.1016/j.healthpol.2017.03.003 · Cited by 16 · see citing works
“challenged by the need to set priorities in the allocation of scarce public resources [1].”
Background
Public engagement in setting healthcare priorities: a ranking exercise in Cyprus
Farmakas, A., Θεοδώρου, Μ., Galanis, P., Karayiannis, G., Ghobrial, S., Polyzos, N. P., Papastavrou, E., Agapidaki, E., & Souliotis, K. N. (2017) · Cost Effectiveness and Resource Allocation · doi:10.1186/s12962-017-0078-3 · Cited by 16 · see citing works
Choosing health technology assessment and systematic review topics: The development of priority-setting criteria for patients’ and consumers’ interests
Bastian, H., Scheibler, F., Knelangen, M., Zschorlich, B., Nasser, M., & Waltering, A. (2011) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462311000547 · Cited by 16 · see citing works
“The literature on priority setting in health does not explore the determinants of patient/consumer interest nor does it address the specific issue of priority setting for information provision (12;13;18).”
Background
Solidarity and cost management: Swiss citizens' reasons for priorities regarding health insurance coverage
Schindler, M., Danis, M., Goold, S. D., & Hurst, S. (2018) · Health Expectations · doi:10.1111/hex.12680 · Cited by 16 · see citing works
“Complete financial coverage (14) Alternative insurance argument (12) Another benefit is more important (9) Point argument (8) Lower level is justifiable (3) Redundancy (2) Financial reasons (170) Cost- benefit argument (70) Importance of financial protection (32) Adverse effect of health costs (18)”
Background
Supporting ageing well research: Findings from a research priority setting exercise
Doolan‐Noble, F., Mehta, P., Waters, D. L., & Baxter, D. G. (2019) · Australian Journal on Ageing · doi:10.1111/ajag.12615 · Cited by 15 · see citing works
How clinical rationing works in practice: A case study of morbid obesity surgery
Owen‐Smith, A., Donovan, J., & Coast, J. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.11.008 · Cited by 15 · see citing works
Principles of Need and the Aggregation Thesis
Gustavsson, E., & Juth, N. (2017) · Health Care Analysis · doi:10.1007/s10728-017-0346-6 · Cited by 15 · see citing works
Priority setting in health care: Attitudes of physicians and patients
Winkelhage, J., Schreier, M., & Diederich, A. (2013) · Health · doi:10.4236/health.2013.54094 · Cited by 14 · see citing works
Value judgment of health interventions from different perspectives: arguments and criteria
Vermeulen, K. M., & Krabbe, P. F. M. (2018) · Cost Effectiveness and Resource Allocation · doi:10.1186/s12962-018-0099-6 · Cited by 14 · see citing works
“According to Golan [2], the key to evaluating the success of prioritization efforts lies in articulating appropriate principles as well as formulating reasons that are grounded in clear value choices [24].”
Background
An ethics analysis of the rationale for publicly funded plastic surgery
Sandman, L., & Hansson, E. (2020) · BMC Medical Ethics · doi:10.1186/s12910-020-00539-6 · Cited by 14 · see citing works

Authors: Sabik, L. M., & Lie, R. K.
Affiliations: National Institutes of Health (US)
Corresponding author: Lie, Reidar K
ORCID: Sabik, Lindsay M
Lie, Reidar K
Venue: International Journal for Equity in Health
Publisher: Springer Science and Business Media LLC
Published: 2008-01-21
Volume: 7
Issue: 1
Pages: 4-4
ISSN: 1475-9276 (ISSN-L)
DOI: 10.1186/1475-9276-7-4
PMC: PMC2248188
OpenAlex: W2077476869
Cited by: 312
References: 85
Citations by year: 2026: 7 · 2025: 8 · 2024: 13 · 2023: 11 · 2022: 13 · 2021: 14 · 2020: 17 · 2019: 37 · 2018: 18 · 2017: 20 · 2016: 16 · 2015: 21 · 2014: 19 · 2013: 23 · 2012: 21
FWCI: 40.84
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
www.springer.com/tdm (unspecified)
Locations: International Journal for Equity in Health (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders: U.S. Department of Health and Human Services
National Institutes of Health
NIH Clinical Center
Topics: Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Social Sciences › Economics, Econometrics and Finance › Finance › Healthcare Systems and Reforms
Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Practices
Keywords: priority setting, healthcare resource allocation, health care justice, health care efficiency, value framework, public participation in health policy, comparative health policy, health care system

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Priority setting in health care: Lessons from the experiences of eight countries

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