Value for money - recasting the problem in terms of dynamic access prioritisation

Area of Science:

• Health economics
• Rehabilitation medicine
• Health services research

Background:

• Achieving value for money in healthcare is a significant challenge.
• Rehabilitation services face increasing demand and limited resources.
• Current access methods may not optimize patient outcomes or resource allocation.

Purpose of the Study:

• To develop a novel approach for optimizing value for money in rehabilitation.
• To implement dynamic prioritization of access based on individual capacity to benefit.
• To enhance the efficiency and equity of rehabilitation service delivery.

Main Methods:

• Critical review of economic evaluation methods.
• Adaptation of a prioritization tool from elective surgical services.
• Qualitative research with expert clinicians and a 1000Minds survey.
• Development of an economic model and observational cohort study.

Main Results:

• The cost-effectiveness frontier is curved, indicating variable patient benefit.
• A dynamic prioritization tool was developed to identify and rank patients by capacity to benefit.
• The tool can be reapplied based on changes in patient clinical status.
• The approach was exemplified using inpatient rehabilitation post-stroke.

Conclusions:

• A dynamic prioritization approach offers a transparent and equitable method for resource allocation.
• This strategy can achieve better value for money in rehabilitation services.
• It provides a framework for guiding access to scarce healthcare resources effectively.