Role In Resource Allocation Decisions Research Articles

The Roles of Social Value Orientation and Anticipated Emotions in Intergroup Resource Allocation Decisions.

How individuals divide resources between themselves and another person is influenced both by their social value orientation (SVO) and the emotions they expect to feel when dividing resources (anticipated emotions). Research has also shown that individuals favor members of their own group (ingroup) over individuals from other groups (outgroup) when allocating resources. The Malaysian multi-ethnic population is a highly relevant context to study the combined effects of intergroup relations and SVO on anticipated emotions and resource allocation. The current studies recruited Malaysian participants to examine whether anticipated emotions and allocation behavior are influenced by the ethnic identity of the person receiving the allocation. Participants completed an SVO measure and rated how they would feel if they were to share resources equally or unequally. They then made allocations between themselves and an ingroup or outgroup member in an economic game. There was no evidence of ingroup favoritism in anticipated emotions and allocation behavior. This may have been due to impression management, social desirability concerns, and/or the use of a population with socially liberal attitudes. The results nevertheless provide support for the notion that anticipated emotions play a key role in resource allocation decisions.

Assessing the Methodological Quality of Economic Evaluations in Integrated Care: Evidence from a Systematic Review

Introduction: In an era of fiscal constraint, economic evaluations are increasingly playing a role in resource allocation decisions to invest in integrated care IC approaches. Posing significant ethical concerns are healthcare investments informed by misleading or biased evidence due to poor methodological quality. We conducted a systematic review to assess the quality of economic evaluations in IC interventions, and identified the challenges associated with the evaluations. Theory/Methods: English publications that reported the concepts of “integrated care” and “economic evaluations”, were searched from the period 2000 to August 2017 in the following databases: PubMed, EMBASE, CINAHL, Web of Science and Scopus. The methodological rigor of the studies was assessed independently by two reviewers using a 30 item-check list adapted from the Consolidated Health Economic Evaluation Reporting Standards CHEERS. Descriptive statements about the challenges experienced when evaluating IC interventions, as reported by authors, were also thematically analysed. Results: We included 40 studies in this review, however, approximately half were considered full economic evaluations; often as part of randomized control trials. Four studies that stated that their research objectives were to examine the cost-effectiveness of the IC interventions, did not perform an incremental cost-effectiveness ratio or a net benefit regression analysis. Of the cohort studies that performed cost comparisons, only one study controlled for potential confounding differences between the intervention and standard care. Valuation of the effects of the IC intervention in the full economic evaluations was often measured using quality-adjusted-life years. In some scenarios where this was challenging to ascertain; particularly in large cohort studies, natural units were used, such as estimated depression-free days. There was variability in the perspectives used, with a minority of the evaluations considering the societal impacts, such as cost shifting between sectors or the economic burden on caregivers. The long-term costs and effects of the interventions were limited in the analyses due to the short observation periods range of 3 months to 5 years. However, some studies attempted to address this through modelling estimated lifetime costs and health outcomes associated with the intervention. Discussions: The complex nature of IC can challenge the application of traditional economic evaluation, making it important to identify these methodological gaps and learn from best-practices. However, other factors may explain the heterogeneous quality of the studies. These may include; the need for further guidance on the methods, the substantial human and financial resources required for data collection and conducting the evaluations, and a lack of economic evaluation culture. Conclusions: This review intended to highlight some of the gaps and opportunities for applying the fundamentals of economic evaluation to IC interventions. Benchmarking economic evaluations against guidelines such as the CHEERS checklist can be a potential catalyst for more consistent and higher quality evidence for decision makers. Limitations: A limitation is the subjective interpretations of the quality of the studies by the reviewers, which could influence how they were rated based on the criteria. However, a major strength is that two-blinded reviewers assessed the studies and based the quality scoring on a consensus.

Economic Evaluation of Pharmacotherapy of Migraine Pain: A Review of the Literature

ABSTRACT. This paper reviews the economic evaluation literature on pharmacotherapy for migraine and identifies important trends and gaps in the literature. Given the tremendous economic burden of migraine and the availability of various therapies for migraine treatment, economic evaluation of alternative therapies plays a critical role in identifying the most cost-effective therapy to optimize health care resource allocation and clinical decisions. Particularly, physicians and clinical administrators are expected to take an active role in resource allocation decisions at the clinical level. Thus, it is important for them to be familiar with the economic evaluation in migraine pain management, and most importantly, methodologies of economic analyses and the associated shortcomings of published estimates. In this paper, the methodological characteristics of these studies are examined and their results are compared and interpreted. Alternative treatment and health outcome measures are defined and data sources described while methods for assessing the direct and indirect costs are explored. Directions for future research are identified and discussed.

The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand

BackgroundThis paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC) for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources.MethodsSemi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics.ResultsTwenty six out of 36 (72%) respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC) in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17%) whose decisions were influenced by economic evaluation evidence.ConclusionThis paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions.

Resources and the Rule of Rescue1

abstract The central issue that I consider in this paper is the use of the so‐called ‘Rule of Rescue’ in the context of resource allocation. This ‘Rule’ has played an important role in resource allocation decisions in various parts of the world. It was invoked in Ontario to overturn a decision not to fund treatment for Gaucher's Disease and it has also been used to justify resource decisions in Israel concerning the same condition. In the paper I consider the nature of the Rule of Rescue and its moral justification. The latter involves consideration of the distinction between agent‐relative and agent‐neutral obligations. If the Rule of Rescue is to be justified, it is plausible to think that it will be in the context of agent‐relative obligations. Two problems with this suggestion are considered: the role of identifiability in the Rule of Rescue and the extent to which policy makers in a health care system can be taken to have such obligations. It is argued that in both cases these problems can be overcome and hence that there is a prima facie obligation to follow the Rule of Rescue.

Economic evaluation of breast cancer screening: A review.

The authors provide a review of the economic evaluation literature of breast cancer screening and identify important trends and gaps in the literature. Healthcare resources are limited and economic evaluation plays a critical role in resource allocation, healthcare policy, and clinical decisions. Many economic evaluations of medical practice, however, are unreliable and do not use appropriate analytic techniques. Three important trends were observed. First, two economic evaluation methods are dominant. Second, a wide range of cost estimates exists across studies. Third, a lack of standardization exists across studies with regard to basic economic evaluation principles. These findings should be considered when conducting future research, analyzing economic evaluations of breast cancer screening, and developing clinical guidelines. Concerns about cost containment in healthcare make it necessary for physicians and clinical administrators to take an active role in resource allocation decisions at the clinical level. For instance, the recent debate on the proper age to begin annual mammography screening involves both resource allocation and clinical issues. Thus, it is important for physicians and clinical administrators to be familiar with the economic evaluation literature of breast cancer screening, economic evaluation methodology, and the associated shortcomings of published estimates.

Assessing Customer Satisfaction with a Master of Business Administration Program: Implications for Resource Allocation

ABSTRACT Many universities are faced with demands to upgrade MBA programs at the same time that available resources to do so are declining. The authors argue that information provided through assessments of customer (i.e., student) satisfaction with current program features should play an important role in resource allocation decisions. An exploratory study of primarily non-traditional MBA students was conducted to investigate the influence of satisfaction with a program's core academic curriculum and program infrastructure on overall program satisfaction and likelihood of recommending the program to a prospective student. For the sample studied, the authors find that program infrastructure is a more important predictor, and that the influence of core curriculum is moderated by student GPA. Results are discussed and implications for MBA program quality enhancement efforts are offered.