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1.
BMJ Global Health ; 7(Suppl 2):A8, 2022.
Article in English | ProQuest Central | ID: covidwho-1871395

ABSTRACT

Trade-offs abound in health care yet depending on where one stands relative to the stages of a pandemic, choice making may be more or less constrained. During the early stages of COVID-19 when there was much uncertainty, health care systems faced greater constraints and focused on the singular criterion of ‘flattening the curve’. As COVID-19 progressed and the first wave diminished (relatively speaking depending on the jurisdiction) more opportunities presented for making explicit choices between COVID and non-COVID patients. Then, as the second wave surged, again decision makers were more constrained even as more information and greater understanding developed. A similar pattern emerged in the third and fourth waves. Moving out of the pandemic to recovery, choice making becomes all the more paramount as there are no set rules to lean back into historical patterns of resource allocation. In fact, the opportunity at hand, when using explicit tools for priority setting based on economic and ethical principles, is significant. This paper focuses on how an explicit priority setting process can be applied both during a pandemic and in the aftermath as the pieces are being put back together. Differences in application relative to the given stage of the pandemic need to be understood so realistic expectations can be placed on those making the resource allocation decisions. In all cases, accountability must be upheld as a key objective even when timelines are seriously constrained and similarly explicit criteria must guide decision making in order to get the most in return for the limited resources available.

2.
Lancet Healthy Longev ; 1(1): e6-e8, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1281657
5.
Lancet ; 397(10288): 2012-2022, 2021 05 22.
Article in English | MEDLINE | ID: covidwho-1219074

ABSTRACT

The health and care sector plays a valuable role in improving population health and societal wellbeing, protecting people from the financial consequences of illness, reducing health and income inequalities, and supporting economic growth. However, there is much debate regarding the appropriate level of funding for health and care in the UK. In this Health Policy paper, we look at the economic impact of the COVID-19 pandemic and historical spending in the UK and comparable countries, assess the role of private spending, and review spending projections to estimate future needs. Public spending on health has increased by 3·7% a year on average since the National Health Service (NHS) was founded in 1948 and, since then, has continued to assume a larger share of both the economy and government expenditure. In the decade before the ongoing pandemic started, the rate of growth of government spending for the health and care sector slowed. We argue that without average growth in public spending on health of at least 4% per year in real terms, there is a real risk of degradation of the NHS, reductions in coverage of benefits, increased inequalities, and increased reliance on private financing. A similar, if not higher, level of growth in public spending on social care is needed to provide high standards of care and decent terms and conditions for social care staff, alongside an immediate uplift in public spending to implement long-overdue reforms recommended by the Dilnot Commission to improve financial protection. COVID-19 has highlighted major issues in the capacity and resilience of the health and care system. We recommend an independent review to examine the precise amount of additional funds that are required to better equip the UK to withstand further acute shocks and major threats to health.


Subject(s)
COVID-19/economics , Health Expenditures/statistics & numerical data , Health Policy/economics , State Medicine/economics , Financing, Government , Humans , Social Support , United Kingdom
6.
Healthc Manage Forum ; 34(5): 252-255, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1166841

ABSTRACT

Trade-offs abound in healthcare yet depending on where one stands relative to the stages of a pandemic, choice making may be more or less constrained. During the early stages of COVID-19 when there was much uncertainty, healthcare systems faced greater constraints and focused on the singular criterion of "flattening the curve." As COVID-19 progressed and the first wave diminished (relatively speaking depending on the jurisdiction), more opportunities presented for making explicit choices between COVID and non-COVID patients. Then, as the second wave surged, again decision makers were more constrained even as more information and greater understanding developed. Moving out of the pandemic to recovery, choice making becomes paramount as there are no set rules to lean back into historical patterns of resource allocation. In fact, the opportunity at hand, when using explicit tools for priority setting based on economic and ethical principles, is significant.


Subject(s)
COVID-19/epidemiology , Health Priorities , Public Health , Resource Allocation , Canada/epidemiology , Decision Making , Humans , Pandemics , Pneumonia, Viral , SARS-CoV-2
7.
Int J Health Policy Manag ; 9(11): 466-468, 2020 11 01.
Article in English | MEDLINE | ID: covidwho-1068321

ABSTRACT

As the coronavirus disease 2019 (COVID-19) pandemic continues to unfold there is an untold number of trade-offs being made in every country around the globe. The experience in the United Kingdom and Canada to date has not seen much uptake of health economics methods. We provide some thoughts on how this could take place, specifically in three areas. Firstly, this can involve understanding the impact of lockdown policies on national productivity. Secondly, there is great importance in studying trade-offs with respect to enhancing health system capacity and the impact of the mix of private-public financing. Finally, there are key trade-offs that will continue to be made both in terms of access to testing and ventilators which would benefit greatly from economic appraisal. In short, health economics could - and we would argue most certainly should - play a much more prominent role in policy-making as it relates to the current as well as future pandemics.


Subject(s)
COVID-19/economics , Health Planning/economics , Health Policy/economics , Canada , Humans , SARS-CoV-2 , United Kingdom
8.
Health Econ Policy Law ; 17(2): 227-231, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-765973

ABSTRACT

Despite denials of politicians and other advisors, trade-offs have already been apparent in many policy decisions addressing the coronavirus disease 2019 pandemic and its social and economic consequences. Here, we illustrate why it is important, from a wellbeing perspective, to recognise such trade-offs, and provide a framework, based on the economic concept of 'marginal analysis', for doing so. We illustrate its potential through consideration of optimising the balance between reducing the reproductive rate (R) of the virus and further opening of the economy. The framework accommodates both perspectives in the health-vs-economy debate whereby, depending on where we are within the marginal analysis framework, either health issues are allowed to dominate or, below some threshold of R and/or background level of infection, health and economic considerations can be traded off against each other. Given the inevitability of such trade-offs, the framework exposes crucial questions to be addressed, such as: the critical value of R and/or background infection, above which health considerations predominate, and which may vary from jurisdiction to jurisdiction; and the value of lives forgone resulting from the small increases in R and/or background infection levels that may have to be tolerated as the economy is gradually opened.


Subject(s)
COVID-19 , Communicable Disease Control/methods , Cost-Benefit Analysis , Humans , Pandemics , SARS-CoV-2
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