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Justice, fairness and equity in health care : exploring the social value of health care interventions

Justice, fairness and equity in health care : exploring the social value of health care interventions
Justice, fairness and equity in health care : exploring the social value of health care interventions

The starting point for the thesis is that when making difficult choices over the provision of health care, the overall value of health care interventions to society is a function not only of the total benefits available from health care, but also the distribution of health care resources across different groups in society.  The thesis investigates this proposition that ‘distribution matters’.

The health technology appraisal process is used as an example of an allocation problem, and the thesis uses the UK National Institute for Health and Clinical Excellence (NICE) as an example of the health technology appraisal process.

A variety of methods are used, including an assessment of general theories of justice, a systematic review of the literature on empirical assessment of distributive preferences, an empirical study to investigate issues around the specific social value related to the severity of health condition, a discrete choice experiment (DCE) to explore a range of key social values and the relative weights placed on these social values.  The research is drawn together in a policy-relevant analysis of social preferences and NHS decision-making.

The thesis develops a hypothesis that the empirical evidence against the importance of severity of health may be a proxy preference for giving priority to a worst off group of patients in health care priority setting; providing empirical evidence to support this hypothesis.  The DCE, in a sample of the general public, finds support for using the social values around level of health improvement, value for money, severity of health, and the availability of other treatments, to offer an insight to the societal value of health care interventions.  The level of health improvement and value for money had the greatest impact, in the discrete choice analysis, with severity of health condition also shown to have an important role in distributive preferences.

University of Southampton
Green, Colin
c57c8e95-7870-4fb1-b3b1-6a2c7442cb30
Green, Colin
c57c8e95-7870-4fb1-b3b1-6a2c7442cb30

Green, Colin (2007) Justice, fairness and equity in health care : exploring the social value of health care interventions. University of Southampton, Doctoral Thesis.

Record type: Thesis (Doctoral)

Abstract

The starting point for the thesis is that when making difficult choices over the provision of health care, the overall value of health care interventions to society is a function not only of the total benefits available from health care, but also the distribution of health care resources across different groups in society.  The thesis investigates this proposition that ‘distribution matters’.

The health technology appraisal process is used as an example of an allocation problem, and the thesis uses the UK National Institute for Health and Clinical Excellence (NICE) as an example of the health technology appraisal process.

A variety of methods are used, including an assessment of general theories of justice, a systematic review of the literature on empirical assessment of distributive preferences, an empirical study to investigate issues around the specific social value related to the severity of health condition, a discrete choice experiment (DCE) to explore a range of key social values and the relative weights placed on these social values.  The research is drawn together in a policy-relevant analysis of social preferences and NHS decision-making.

The thesis develops a hypothesis that the empirical evidence against the importance of severity of health may be a proxy preference for giving priority to a worst off group of patients in health care priority setting; providing empirical evidence to support this hypothesis.  The DCE, in a sample of the general public, finds support for using the social values around level of health improvement, value for money, severity of health, and the availability of other treatments, to offer an insight to the societal value of health care interventions.  The level of health improvement and value for money had the greatest impact, in the discrete choice analysis, with severity of health condition also shown to have an important role in distributive preferences.

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Published date: 2007

Identifiers

Local EPrints ID: 466339
URI: http://eprints.soton.ac.uk/id/eprint/466339
PURE UUID: b84ee751-f4ca-4033-ad3b-21675b0cc631

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Date deposited: 05 Jul 2022 05:11
Last modified: 16 Mar 2024 20:38

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Contributors

Author: Colin Green

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