Addressing prioritization in healthcare amidst a global pandemic.

Craig Mitton,Stuart Peacock,Cam Donaldson,Francois Dionne

doi:10.1177/08404704211002539

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.

Highlights

Setting priorities and allocating scarce resources is an activity that healthcare decision makers have always had to address, both in Canada and elsewhere.[1]
Use of a formal approach to priority setting and resource allocation would typically involve the eight steps illustrated in Figure 1.6 There is room within this type of framework for the application of high-quality evidence, including the form often produced in health technology assessments, and further, there are multiple opportunities for substantive public engagement.[7]
We are strong proponents for the use of explicit, evidence-informed tools for setting priorities and allocating resources in healthcare. This sentiment has recently been echoed by others in the healthcare management space in calling for more transparency in decision making.[17]. Such tools are always relevant, their application can be severely limited during a pandemic due to extreme constraints on choice making

Summary

Addressing prioritization in healthcare amidst a global pandemic

Article reuse guidelines: Craig Mitton, PhD1,2 ; Cam Donaldson, PhD3; Francois Dionne, PhD2; sagepub.com/journals-permissions and Stuart Peacock, DPhil[4,5,6]

Introduction

Priority setting tools

Conclusion