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Priority setting in health care: Lessons from the experiences of eight countries
Open accessAbstract
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 vary across different countries [16], illustrating that priority-setting is complex”
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Cites
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Núñez, A., & Chi, C. (2021) · Figshare · doi:10.6084/m9.figshare.14131086
Kvestad, C. A., Holte, I. R., Reitan, S. K., Chiappa, C. S., Helle, G. K., Skjervold, A. E., Rosenlund, A. M. A., Watne, Ø., Brattland, H., Helle, J., et al. (2024) · Figshare · doi:10.6084/m9.figshare.25389458
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Mos, P., & Reckers‐Droog, V. (2026) · Health Economics Policy and Law · doi:10.1017/s1744133125100327
“Several countries – including the Netherlands, England and Wales, Norway, Sweden and Denmark – introduced explicit decision-making frameworks to guide the allocation of healthcare resources on the national level (Reckers-Droog et al., 2018; Sabik and Lie, 2008).”
Gustafsson, I.-B., Wallin, L., Winblad, U., & Fredriksson, M. (2026) · BMC Health Services Research · doi:10.1186/s12913-026-14451-z
“Although priority setting is essential for balancing resources to promote equity and improve population health, it can be an emotionally demanding decision-making process [11, 12], particularly for clinicians responsible for implementing prioritization decisions.”
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Prioritising time for communication in healthcare—a normative analysis
Björk, J. (2026) · Medicine Health Care and Philosophy · doi:10.1007/s11019-026-10364-0
“The situation makes While priority setting is relevant in all types of healthcare organisations, some publicly financed healthcare systems have taken a leading role in formulating priority setting frameworks (Sabik and Lie 2008; Glassman and Chalkidou 2012; Seixas et al. 2021).”
Service Choices: Priority Setting in Finnish Health Care
Kimmel, K.-M. (2019) · Retfærd · doi:10.18261/ret.42.4.2
Priority-setting in health care: A challenge to solidarity?
Kieslich, K. (2026) · Social Theory & Health · doi:10.1057/s41285-026-00260-1
“The problem with this line of thought, however, is that first, there is little empirical evidence to suggest that the reasons for decisions are made clear in practices of priority-setting (e.g. Kieslich et al. 2024; Robinson et al. 2012; Sabik and Lie 2008; Reichenbach 2002).”
Boëthius, D., Krevers, B., & Nedlund, A. (2026) · SSM - Qualitative Research in Health · doi:10.1016/j.ssmqr.2026.100875
Metadata
- Authors
- Sabik, L. M., & Lie, R. K.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Lie, Reidar K
- Venue
- International Journal for Equity in Health
- Published
- 2008-01-21
- Volume
- 7
- Issue
- 1
- Pages
- 4-4
- ISSN
- 1475-9276 (ISSN-L)
- 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
- 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
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Reforms
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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