[Priority setting in healthcare. What can Germany learn from other countries?]

Area of Science:

• Health Policy
• Healthcare Management
• Public Health

Background:

• International healthcare systems grapple with priority setting, a debate ongoing since the late 1980s.
• Various countries (Norway, Sweden, Denmark, Oregon, The Netherlands, New Zealand) have implemented diverse priority-setting strategies.
• Early Scandinavian efforts relying on public consensus and professional discretion proved ineffective.

Purpose of the Study:

• To review and compare international approaches to healthcare priority setting.
• To analyze the effectiveness of different priority-setting principles and their impact on healthcare benefits.
• To identify common challenges and outcomes associated with healthcare prioritization.

Main Methods:

• Comparative analysis of international priority-setting models.
• Review of policy documents and implementation timelines from various countries.
• Evaluation of the impact of different approaches on healthcare expenditure and transparency.

Main Results:

• Priority setting based on public consensus and professional discretion showed no significant effect.
• Approaches utilizing concrete lists of indication-treatment pairs led to moderate expenditure reduction and increased care transparency.
• Commonalities across countries include intense public debate, lengthy implementation periods, and avoidance of age/gender/social status-based prioritization.

Conclusions:

• Concrete lists for healthcare priority setting offer more tangible results than consensus-based models.
• Effective healthcare priority setting requires careful consideration of implementation timelines and public engagement.
• Priority setting is increasingly viewed as a complementary tool alongside health technology assessments and clinical guidelines.