Equity in healthcare resource allocation decision making: A systematic review

Area of Science:

• Health Policy
• Public Health
• Healthcare Management

Background:

• Healthcare equity is a critical component of resource allocation.
• Existing definitions of equity in healthcare are often inconsistent and lack operational clarity.
• Policymakers and clinicians require a clear, society-aligned definition of equity for decision-making.

Purpose of the Study:

• To systematically identify and classify elements of endorsed definitions of equity in healthcare.
• To provide a framework for developing operational definitions of equity that reflect societal values.
• To aid policymakers, managers, and clinicians in making equitable healthcare resource allocation decisions.

Main Methods:

• Systematic review of literature on healthcare equity definitions.
• Thematic analysis of explicit and implicit definitions of equity from 74 selected papers.
• Searches conducted across multiple databases (AMED, CINAHL plus, Ovid Medline, Scopus, PsychInfo, ProQuest) in April 2015.

Main Results:

• Identified 74 relevant papers, with 60 providing explicit definitions and 14 discussing implicit elements of equity.
• Five key themes emerged: equalisation across the health service chain, need/potential benefit, groupings of equalisation, caveats to equalisation, and 'close enough is good enough'.
• Significant inconsistency exists in the definitions of equity endorsed by various authors.

Conclusions:

• Current definitions of healthcare equity are inconsistent and require greater explicitness.
• Operational definitions must address the five identified thematic areas for effective application in healthcare resource allocation.
• Developing a consensus on equity definitions is crucial for fair and just healthcare systems.