HEDS is part of the School of Health and Related Research (ScHARR) at the University of Sheffield. We undertake research, teaching, training and consultancy on all aspects of health related decision science, with a particular emphasis on health economics, HTA and evidence synthesis.

Wednesday, 3 September 2014

Societal values in trade-offs between equity and efficiency

From the NICE website:

"The Citizens Council, which advises NICE, has published its draft report on what
societal values should influence NICE’s decisions about getting the best value from the money spent (efficiency) whilst ensuring those resources are shared fairly (equity). NICE is now asking the wider public for views on the report.

To help explore these areas, the Council debated a series of case studies. These illustrated the difficulties involved in deciding whether money should be spent on caring for small numbers of people with high-levels of need, or instead using the same money to provide care for more people but who may have less need.  One example was a local council proposing to close a respite day centre providing specialist care for a small number of severely disabled children, and instead wanting to use that money to open a playgroup for all children.

Image by Juhan Sonin via Flickr CC BY 2.0
The Citizens Council concluded that there are a number of values that apply across public health, health, and social care when making decisions on equity and efficiency, including: collective responsibility, dignity, fairness, honesty, and humanity.
They also decided that there are some additional values that were particular priorities for each of the three areas of care, including:
  • public health: individual rights; maximising total benefit; safeguarding the vulnerable
  • social care: right to health and welfare for all; independence; individual choice
  • healthcare: justice; respect; being non-judgmental.
The council also highlighted a special circumstance, where greater emphasis on equity is needed, is public health intervention in times of epidemic or natural disaster.  They felt that a special circumstance, where a greater emphasis on efficiency is needed, is non-essential cosmetic surgery."

The report is available here.