Severity as a Priority Setting Criterion: Setting a Challenging Research Agenda.

Area of Science:

• Health Policy
• Medical Ethics
• Health Economics

Background:

• Healthcare priority setting is crucial for efficient, fair, and equitable resource allocation.
• Cost-effectiveness is a common policy focus, but ethical tensions between utilitarian and deontological concerns persist.
• Severity criteria are increasingly used to address these gaps in priority setting.

Purpose of the Study:

• To provide a historical overview of severity criteria in Norway and Sweden.
• To analyze severity as a multidimensional concept encompassing need, urgency, fairness, duty to save lives, and human dignity.
• To identify key questions for future research on severity in healthcare priority setting.

Main Methods:

• Historical analysis of severity criteria in Scandinavian countries.
• Philosophical and ethical examination of the concept of severity.
• Identification of pertinent questions for decision-making under resource scarcity.

Main Results:

• Severity criteria have evolved differently in Norway and Sweden.
• Severity is a complex, multidimensional concept influenced by local values and ethical considerations.
• Current understanding of severity in healthcare priority setting is insufficient.

Conclusions:

• Severity is a poorly understood concept requiring substantial further research.
• Developing a robust ethical and philosophical framework for severity is essential for future healthcare priority setting.
• This article proposes a research agenda to advance the understanding and application of severity criteria.