Availability Of Healthcare Resources Research Articles

Racial disparities in cancer care, an eyeopener for developing better global cancer management strategies.

In the last few decades, advancements in cancer research, both in the field of cancer diagnostics as well as treatment of the disease have been extensive and multidimensional. Increased availability of health care resources and growing awareness has resulted in the reduction of consumption of carcinogens such as tobacco; adopting various prophylactic measures; cancer testing on regular basis and improved targeted therapies have greatly reduced cancer mortality among populations, globally. However, this notable reduction in cancer mortality is discriminate and reflective of disparities between various ethnic populations and economic classes. Several factors contribute to this systemic inequity, at the level of diagnosis, cancer prognosis, therapeutics, and even point-of-care facilities. In this review, we have highlighted cancer health disparities among different populations around the globe. It encompasses social determinants such as status in society, poverty, education, diagnostic approaches including biomarkers and molecular testing, treatment as well as palliative care. Cancer treatment is an active area of constant progress and newer targeted treatments like immunotherapy, personalized treatment, and combinatorial therapies are emerging but these also show biases in their implementation in various sections of society. The involvement of populations in clinical trials and trial management is also a hotbed for racial discrimination. The immense progress in cancer management and its worldwide application needs a careful evaluation by identifying the biases in racial discrimination in healthcare facilities. Our review gives a comprehensive evaluation of this global racial discrimination in cancer care and would be helpful in designing better strategies for cancer management and decreasing mortality.

Daily changes in spatial accessibility to ICU beds and their relationship with the case-fatality ratio of COVID-19 in the state of Texas, USA

During the COVID-19 pandemic, many patients could not receive timely healthcare services due to limited availability and access to healthcare resources and services. Previous studies found that access to intensive care unit (ICU) beds saves lives, but they overlooked the temporal dynamics in the availability of healthcare resources and COVID-19 cases. To fill this gap, our study investigated daily changes in ICU bed accessibility with an enhanced two-step floating catchment area (E2SFCA) method in the state of Texas. Along with the increased temporal granularity of measurements, we uncovered two phenomena: 1) aggravated spatial inequality of access during the pandemic, and 2) the retrospective relationship between insufficient ICU bed accessibility and the high case-fatality ratio of COVID-19 in rural areas. Our findings suggest that those locations should be supplemented with additional healthcare resources to save lives in future pandemic scenarios.

AN ANALYSIS OF HOMELESSNESS IN UNITED STATES OF AMERICA: POLICY IMPLICATIONS

This study analyzed the perceived causes of homelessness in United States of America, characteristics of homelessness in United States of America by family types, percentage of people experiencing homelessness by community setting to assist policymakers to develop programs and policy frameworks to address homeless issues across the country (USA). Homelessness affects the entire country. Homelessness is not someone else’s issue but national in scope. The issue of homelessness has a ripple effect throughout the community. It impacts the availability of healthcare resources, crime and safety, the workforce, and the use of tax dollars. Further, homelessness impacts the present as well as the future growth of the nation. Above all, the knowledge of homelessness benefits all of us to break the cycle of homelessness, one person, one family at a time. Therefore, in order to assist policymakers to effectively tackle the issue of homelessness, the study adopted a descriptive research design to analyze the policy issue of homelessness in United States of America. The data source for the study analysis came from the 2021 Census data, the 2022 Annual Homelessness Assessment Report by U.S. Department of Housing and Urban Development, and the National Alliance to END HOMELESSNESS. The study revealed that most of the homeless peoples were individuals without families and children (i.e. 70 percent), and the rest were people living in families with children. Also, the study further revealed in the homelessness dataset that males are far more likely to experience homelessness than their female counterparts. That is, out of every 10,000 males, 22 are homeless (representing a total male homeless population of 352,211), while for women and girls, that number is 13 homeless (representing a total female homeless population of 223,578). In addition, the homelessness historical data revealed that marginalized groups are more likely to be disadvantaged within housing and homelessness spheres. It also revealed that higher unemployment rates, lower incomes, less access to healthcare, and higher incarceration rates are some of the likely factors that contribute to higher rates of homelessness among people of color, and marginalized groups. Also, historically marginalized racial groups are far more likely to experience homelessness as a result of segregation and discrimination in employment and housing, among other things. The study strongly recommends that the federal government should create more programs and employment opportunities that will give equal opportunities to all. The study further recommends that by taking into consideration programs that will create more affordable houses, and to also take care of both natural shocks (i.e. hurricanes, fire outbreaks, etc.), and human shocks (i.e. domestic abuse) will go a long way to help the country minimize the homelessness rate. Keywords : Homelessness, Marginalized, Housing, Sheltered, Policymakers, Discrimination, Unsheltered, Poverty, Unemployment, Programs DOI: 10.7176/IAGS/98-05 Publication date: March 31 st 2023

Prophylaxis protects infants with congenital heart disease from severe forms of RSV infection: an Italian observational retrospective study

BackgroundIn children with congenital heart disease (CHD) respiratory syncytial virus (RSV) infection may have a severe course, with increased risk of morbidity and mortality, requiring hospital admission and intensive care. The aim of the present study was to evaluate the effect of prophylaxis with palivizumab in preventing RSV-associated hospitalization in infants with CHD.MethodsWe carried out an observational, retrospective study in a paediatric cardiology division at a secondary-care centre in Italy, extracting from the database children with CHD who, from November 2004 to March 2022, matched the criteria for palivizumab prophylaxis, to evaluate the hospitalization rate in CHD patients with and without palivizumab prophylaxis and their RSV-related hospitalization characteristics compared with a group of children without CHD and no other underlying clinical conditions (control group, CG), hospitalized for RSV infection.ResultsOne hundred twenty-eight children with CHD were enrolled in the study, mainly (71.9%) with increased pulmonary flow, and received palivizumab prophylaxis. Twenty-seven received hospital care for bronchiolitis. Almost all CHD patients hospitalized for bronchiolitis (26 out of 27) received partial prophylaxis (≤ 3 doses). CHD patients with bronchiolitis stay longer in the hospital than control (14.4 ± 21.7 days vs 6.2 ± 2.3 days) some of which require intensive care (n = 4).ConclusionsOur study provides evidence of the efficacy of palivizumab in protecting patients with hemodynamically significant CHD under the age of 2 years from RSV disease and its life-threatening complications. Reducing hospitalisation rate, morbidity, and mortality in this category of patients, passive immune prophylaxis with palivizumab may impact healthcare resource availability and utilisation.

Distribuição da COVID-19 e dos recursos de saúde na Amazônia Legal: uma análise espacial

Abstract Spatial analysis can help measure the spatial accessibility of health services with a view to improving the allocation of health care resources. The objective of this study was to analyze the spatial distribution of COVID-19 detection rates and health care resources in Brazil’s Amazon region. We conducted an ecological study using data on COVID-19 cases and the availability of health care resources in 772 municipalities during two waves of the pandemic. Local and global Bayesian estimation were used to construct choropleth maps. Moran’s I was calculated to detect the presence of spatial dependence and Moran maps were used to identify disease clusters. In both periods, Moran’s I values indicate the presence of positive spatial autocorrelation in distributions and spatial dependence between municipalities, with only a slight difference between the two estimators. The findings also reveal that case rates were highest in the states of Amapá, Amazonas, and Roraima. The data suggest that health care resources were inefficiently allocated, with higher concentrations of ventilators and ICU beds being found in state capitals.

Health status and health care utilization profiles of adolescents with disabilities

BackgroundAdolescents with physical disabilities of childhood often require a transition from pediatric to adult systems as part of life-long, comprehensive health care once they reach 18 years of age. The process of transition can be complex, challenging, and influenced by health-related factors and availability of health care resources. ObjectiveTo provide a baseline profile of health-related quality of life, health management, social participation, and health care utilization for adolescents 16 years of age with spina bifida (SB), acquired brain injury (ABI), or cerebral palsy (CP) in Toronto, Canada. MethodsA cross-sectional survey design was used. A sample was drawn from a large, urban pediatric rehabilitation hospital as part of a prospective, longitudinal, observational mixed-methods study. Seven English language, paper-copy standardized measures were completed; measures were organized across the three domains of interest. Health care utilization data were obtained from population-based, health services administrative datasets held by ICES. These data included outpatient physician visits, emergency department visits, and hospitalizations over a 12-month period, beginning at their 16th birthday. ResultsThe sample comprised 99 participants: survey measures were completed by 59 participants (12 SB, 19 ABI, and 28 CP) and health care utilization obtained for 92 participants (19 SB, 25 ABI, and 48 CP). Baseline scores across measures and rates of health care utilization are provided. All three groups reported relatively good health-related quality of life. Youth with CP had lower scores on health utility, health management, and social participation, compared with the SB and ABI groups. Youth with SB had slightly higher health care utilization in the 12-month period after their 16th birthday, compared with the ABI and CP groups. ConclusionsThis cross-sectional survey collected comprehensive health status and health care utilization data on 16-year-old youth with SB, ABI, and CP in Toronto, Canada. With few exceptions, the CP group consistently scored lower across measurement domains. These baseline data may be useful for hospital administrators, policy makers, and researchers examining changes in health-related quality of life, health management, social participation, and health care utilization among youth with SB, ABI, and CP, particularly in the context of transition planning and evaluation.

Distribution of COVID-19 cases and health resources in Brazil's Amazon region: a spatial analysis.

Spatial analysis can help measure the spatial accessibility of health services with a view to improving the allocation of health care resources. The objective of this study was to analyze the spatial distribution of COVID-19 detection rates and health care resources in Brazil's Amazon region. We conducted an ecological study using data on COVID-19 cases and the availability of health care resources in 772 municipalities during two waves of the pandemic. Local and global Bayesian estimation were used to construct choropleth maps. Moran's I was calculated to detect the presence of spatial dependence and Moran maps were used to identify disease clusters. In both periods, Moran's I values indicate the presence of positive spatial autocorrelation in distributions and spatial dependence between municipalities, with only a slight difference between the two estimators. The findings also reveal that case rates were highest in the states of Amapá, Amazonas, and Roraima. The data suggest that health care resources were inefficiently allocated, with higher concentrations of ventilators and ICU beds being found in state capitals.

Gastrointestinal infections after earthquake

Natural disasters such as earthquakes resulting in infrastructural damage in affected areas can also result in outbreaks of infectious diseases, with infections usually beginning within 4 days of the initial impact. Gastrointestinal diseases are prevalent due to the lack of food and water supplies. The rates of diarrheal illnesses following natural disasters are mainly influenced by the (i) endemicity of intestinal pathogens before the disaster, (ii) the availability of safe water and sanitation facilities, (iii) the severity of the disaster, (iv) the degree of crowding and (v) the availability of healthcare resources. Among the causative agents of gastroenteritis, viral infections are the most common ones, followed by bacterial and parasitic infections. Maintenance of sanitation and availability of primary healthcare are critical for early diagnosis, treatment and prevention of infectious disease outbreaks following natural disasters.

Health economic evaluation on population-based Helicobacter pylori eradication and endoscopic screening for gastric cancer prevention.

Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori (H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.

Comparative Health Status of Women of Childbearing Age in Urban and Non-urban Communities in Malaysia

Background Women’s health and access to healthcare can be affected by diverse factors such as affluence, cultural norms and availability of healthcare resources. In this study, we compared health status parameters among women of childbearing age from different ethnic groups living in urban and non-urban communities in Malaysia. Methods Women under the age of 45-years in urban and non-urban areas of Malaysia were invited to participate in this study. In total, 1500 women were approached, and of these 1435 agreed to participate and met our inclusion criteria. Information about personal healthcare, communication with healthcare practitioners, sources of health information, health concerns, weight management, as well as socio-demographic characteristics were obtained using a questionnaire which was adapted from the Women’s Health National Survey 2016 of Australia. Results Women of Indian descent made up a higher proportion of respondents in non-urban areas. Women in non-urban areas were less likely to have a higher-level education and belonged to households with a lower annual income. Non-urban respondents were also more likely to be married and to have more children. Women from non-urban locations were less likely to be overweight or exhibit sedentary behaviors. Women from non-urban sites were more interested in improving their health status, more likely to attend routine health checks, and less likely to use dietary supplements. Conclusion Women from non-urban areas exhibit healthier behaviours than their urban counterparts and have a lower prevalence of obesity. This is despite poorer access to healthcare provision in rural communities.

Cervical cancer screening coverage and the availability of healthcare resources for public health midwives in the Jaffna district

Effective cervical cancer screening requires high rates of service coverage. Very little is known about the determinants of cervical cancer screening coverage in Sri Lanka. This study aims to describe the association between the availability of resources for public health midwives (PHM), sociodemographic and work-related factors, and cervical cancer screening coverage in the Jaffna district in northern Sri Lanka. A descriptive cross-sectional study was carried out among field PHMs working in Jaffna District in 2019. Data were collected with a pre-tested, self-administered questionnaire at the monthly Medical Officer of Health conferences. Data were analysed with SPSS (v21). Frequencies, percentages and the Chi Squared test were used in the analysis. The critical level was set at 0.05. A total of 131 (of 144) field PHMs working in Jaffna district participated in the study (response rate 91%). Over half (n=67, 51%) had >10 years’ work experience, 44% (n=58) covered an additional PHM area and 48% (n=63) reported having received training in organising cervical cancer screening. In the sample, 49% (n=64) of PHMs reported having all essential facilities for cervical cancer screening and 48 (75%) achieved ≥50% coverage. Although 11 PHMs (8%) achieved 100% coverage, less than half the sample (n=54, 41%) achieved the Ministry of Health target of ≥70% coverage. Achieving 50% coverage was significantly associated with the availability of all essential facilities (p=0.01) and work experience (p=0.03), but not with having received training in organising cervical cancer screening (p=0.73). None of the selected sociodemographic and work-related factors were associated with having achieved the target of ≥ 70% coverage. Public health facilities and human resources are essential for improving cervical cancer screening coverage in Jaffna and elsewhere in Sri Lanka.

Population-based study on coverage and healthcare processes for cancer during implementation of national healthcare insurance in Indonesia.

A national healthcare insurance has been implemented in Indonesia since 2014. Although cancer care currently represents a smaller part of the healthcare support, the demographic development will lead to a rapid growth of the population within age groups at cancer risk. This requires strategic and developmental planning of cancer care resources. Based on data of the national healthcare insurance, current cancer care processes and their determinants were evaluated. Nationwide reimbursement data as well as demographic, economic and healthcare infrastructure data were used for the study. Poor and underserved population was stratified according to the national classification system. Availability of healthcare resources was evaluated at provincial level. Cancer care usage was analysed applying descriptive and multivariate statistical approaches (regression, cluster analysis, tree classification). Cancer care was provided in primary care (PHC) for 2.6/1000 and advanced care (AHC) for 4.8/1000 participants within the family-based membership structure. Regression analysis revealed human resource availability in rural/remote areas a determinant for cancer PHC. Cancer care in AHC was determined by PHC provided by general practitioners (GP), availability of AHC infrastructure (Class A & B hospital beds) and treatment migration between provinces. Tree classification confirmed predominant roles of GP, AHC infrastructure and referral between cancer care provider levels. Cancer care will gain much higher importance for the Indonesian healthcare system within the next decade. Infrastructure, human resources, and process development should avoid rising overload of cancer care delivery by targeting reduction of treatment migration (availability of GPs in rural/remote provinces), improvement of referral systems (effective clinical selection processes and back-referral) and AHC cancer care structures (regional distribution of Class A & B hospitals). This project was supported by grants from Centre for Research, Publication, and Community Development Muhammadiyah University of Yogyakarta (SW, ID), and data provision by BPJS Indonesia.

Health System Decentralization: Creating as Many Problems Than It Solves? Comment on "The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis".

This comment draws on the study by Rotulo et al about the effects of fiscal decentralization on access, utilization and availability of healthcare resources across Italian regions. We start by discussing the recent trends in health system decentralization worldwide, and then reflect on the rationale and main benefits and the key complexities and challenges of this much debated reform. We address these issues with reference to the recent experience of Italy as well as that of other comparable highly decentralized countries, most notably Spain, paying particular attention to their similarities and contrasts. We conclude that decentralization of health services poses complex challenges and trade-offs which may require careful design of equalisation mechanisms, framework regulation and efficient coordination mechanisms by central and sub central governments.

An Examination of the Stochastic Distribution of Spatial Accessibility to Intensive Care Unit Beds during the COVID-19 Pandemic: A Case Study of the Greater Houston Area of Texas.

Sufficient and reliable health care access is necessary for people to be able to maintain good health. Hence, investigating the uncertainty embedded in the temporal changes of inputs would be beneficial for understanding their impact on spatial accessibility. However, previous studies are limited to implementing only the uncertainty of mobility, while health care resource availability is a significant concern during the coronavirus disease (COVID‐19) pandemic. Our study examined the stochastic distribution of spatial accessibility under the uncertainties underlying the availability of intensive care unit (ICU) beds and ease of mobility in the Greater Houston area of Texas. Based on the randomized supply and mobility from their historical changes, we employed Monte Carlo simulation to measure ICU bed accessibility with an enhanced two‐step floating catchment area (E2SFCA) method. We then conducted hierarchical clustering to classify regions of adequate (sufficient and reliable) accessibility and inadequate (insufficient and unreliable) accessibility. Lastly, we investigated the relationship between the accessibility measures and the case fatality ratio of COVID‐19. As result, locations of sufficient access also had reliable accessibility; downtown and outer counties, respectively, had adequate and inadequate accessibility. We also raised the possibility that inadequate health care accessibility may cause higher COVID‐19 fatality ratios.

Asian Pacific Society of Cardiology Consensus Statements on the Diagnosis and Management of Obstructive Sleep Apnoea in Patients with Cardiovascular Disease.

Obstructive sleep apnoea (OSA) is strongly associated with cardiovascular disease (CVD). However, evidence supporting this association in the Asian population is scarce. Given the differences in the epidemiology of CVD and cardiovascular risk factors, as well as differences in the availability of healthcare resources between Asian and Western countries, an Asian Pacific Society of Cardiology (APSC) working group developed consensus recommendations on the management of OSA in patients with CVD in the Asia-Pacific region. The APSC expert panel reviewed and appraised the available evidence using the Grading of Recommendations Assessment, Development, and Evaluation system. Consensus recommendations were developed and put to an online vote. Consensus was reached when 80% of votes for a given recommendation were in support of ‘agree’ or ‘neutral.’ The resulting statements provide guidance on the assessment and treatment of OSA in patients with CVD in the Asia-Pacific region. The APSC hopes for these recommendations to pave the way for screening, early diagnosis and treatment of OSA in the Asia-Pacific region.

Assessment of primary healthcare accessibility and inequality in north-eastern Kazakhstan.

Out of the many aspects of health care, the concept of physical accessibility is a priority that not only encompasses availability of health care resources, but also requires that they are easily accessible for all. To assess this factor as expressed in terms of the number of available physicians in the north-eastern part of Kazakhstan, we used the enhanced two-step float catchment area in a geographic information system approach. The Gini index and the Lorentz curve were used to evaluate the economic inequality within this region. Based on the data obtained, we developed models to increase the availability of health care considering allocation of additional primary health care resources. A low to zero index was found to be typical for most rural settlements, which currently make up less than 15% of the total population. We also identified a correlation between the index of accessibility and that of inequality, which indicates that areas with high accessibility show a more equitable distribution of resources. The developed location/ allocation models of additional primary health care resources can be useful in implementing government initiatives to improve the availability of primary health care in rural areas.

Head-to-head comparison of a risk-adapted screening strategy using various risk prediction models in detecting colorectal neoplasm.

The risk-adapted screening strategy showed satisfying colorectal cancer (CRC) screening yield and efficiency. We therefore further explored the diagnostic performance variation of this strategy using different risk prediction models. A literature search was conducted to identify studies evaluating risk models for advanced colorectal neoplasm (ACN). The included models were retrospectively validated in a subset sample (N=3219) from a population-based CRC screening trial in China. Diagnosis-related indictors were compared between the risk-adapted screening strategy using different models and the fecal immunochemical test (FIT)-only strategy. For simulated populations with ACN prevalence of 3% to 12%, the trade-off of additional false positives for each additional true positive were calculated. We included 14 eligible risk models with the area under the curves ranging 0.570 to 0.652 in the validation set. The overall sensitivities of the risk-adapted screening strategy using different risk models for ACN varied from 46.0% to 69.8%, higher than FIT (21.9%), but at the expense of specificities (51.6% to 78.3% vs 97.1%). For population having ACN prevalence of 3%, risk-adapted screening strategies needed 20.5 to 31.1 additional false positives for each additional true positive compared with FIT, and respective number would substantially reduce (4.7 to 7.1) as the ACN prevalence increased to 12%. Risk-adapted screening strategy using the current risk models showed improved sensitivity for ACN compared with FIT, at the cost of increased colonoscopy workload. The optimal strategy for screening practice should be tailored considering the disease burden and availability of healthcare resources.

Early impact of COVID-19 pandemic on heart transplant volumes in Asia and Oceania: results from the Global Observatory on Donation and Transplantation (GODT)

Funding AcknowledgementsType of funding sources: None.IntroductionMassive demand for healthcare services worldwide following the emergence of coronavirus disease 2019 (COVID-19) has limited the availability of healthcare resources needed for certain high-complexity procedures, including orthotopic heart transplantation (OHT). Whereas the negative impact of COVID-19 pandemic on several elective procedures has been well-documented, data on regional changes in OHT volumes after COVID-19 are limited. Therefore, we aimed to quantify the impact of COVID-19 pandemic on OHT volumes in Asia and Oceania.MethodsUsing data from the Global Observatory on Donation and Transplantation (GODT), the world"s most comprehensive source of data on organ donation and transplantation, we recorded the number of OHT procedures performed in years 2019 (pre-COVID-19 era) and 2020 (COVID-19 era). The analysis was limited to countries with reported OHT data within Asia and Oceania (Australia, China, India, Iran, Israel, Japan, New Zealand, Russian Federation, Saudi Arabia, Thailand, Turkey, and the United Arab Emirates). OHT rates were reported for each country per million population (PMP), and change in the COVID-19 era was reported as percentage of the pre-COVID-19 rates. The association of total COVID-19 cases with relative reduction in OHT was evaluated using linear regression.ResultsAcross the Asia/Oceania region, number of OHT in COVID-19 era (median 0.64 procedures PMP, IQR 0.28, 2.15) was significantly lower compared with the pre-COVID-19 era (median 1.18 procedures PMP, IQR 0.49, 2.50), with a median change of -0.29 (IQR -0.70, -0.08; P = 0.04). The impact of COVID-19 on OHT was most pronounced in Turkey, United Arab Emirates, and India, where OHT volumes decreased by 75.4%, 60.8%, and 53%, respectively. Country-level reduction in OHT volumes was not associated with total number of COVID-19 cases during the year 2020 in that country (r = 0.31; P-value = 0.3).ConclusionThe number of heart transplants during the early phase of COVID-19 pandemic significantly decreased in ­­­most countries of the Asia/Oceania region. Furthermore, the change in OHT volumes did not correlate with the total number of recorded COVID-19 cases, suggesting the pandemic’s impact on OHT numbers extended beyond limiting availability of resources. Identifying factors leading to OHT deferral during COVID-19 pandemic will advance our understanding of the pandemic’s true impact on the care of advanced heart failure patients in the region. Figure.

Analytical observational study evaluating global pandemic preparedness and the effectiveness of early COVID-19 responses in Ethiopia, Nigeria, Singapore, South Korea, Sweden, Taiwan, UK and USA

ObjectivesAn analysis of early country-specific COVID-19 strategies and the impact of policies, healthcare resources and cultural influences on their effectiveness.DesignAnalytical observational study.SettingUSA, UK, Sweden, South Korea, Singapore, Taiwan, Ethiopia and...

"Just" Utility? A Bioethical Analysis of COVID-19 Resource Allocation

COVID-19 has brought into focus the bioethical challenge of resource allocation by straining healthcare delivery in limiting the availability of healthcare resources. While the bioethical principle of autonomy has typically taken precedence for medical practices, with the struggle of resource allocation, the bioethical principles emerging as front-line and conflicting have been utility and justice. Balancing these ideals has been challenging because while utility has demanded that society make decisions maximizing good and minimizing harm, justice has emphasized all people getting their due, despite if most efficient. Looking at how these principles could work without compromising each other, the question how a “just” utility, or a utility well-balanced with justice, could be attained has emerged because while utility has encouraged policies that would save the most lives in dire situations, it has inadvertently allowed for the magnification of pre-pandemic inequities disproportionately impacting the marginalized, marking an issue of justice. The conversation has proven complex when considering the ventilator crisis, showing the importance of resource allocation for public health emergencies. To grasp the scope of resource allocation challenges during COVID-19, the role of bioethical principles in making decisions, the concept of “just” utility, and the implications of resource allocation (including questions of accountability and use of innovative technologies) will be evaluated. Advocated for will be the consistent discussion of resource allocation strategies by diverse community members who take responsibility together, health officials being transparent during crisis situations, and using bioethical principles to predict and combat inequities that might be amplified during crises.