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Weighting in the dark: resource allocation in the new NHS
T A Sheldon1, G D Smith, G Bevan
1Centre for Health Economics, University of York, Heslington.
BMJ (Clinical Research Ed.)
|March 27, 1993
Summary
Resource allocation formulas for healthcare face limitations due to the difficulty in measuring true need and costs. Empirical formulas aiming for precision and equity may be fruitless, necessitating justifiable impacts beyond formula composition.
Area of Science:
- Health economics
- Public health policy
- Resource allocation
Background:
- National resource allocation to health authorities relies on a weighted capitation formula.
- The current formula uses hospital utilization as a proxy for healthcare need, a method with inherent limitations.
Purpose of the Study:
- To critique the reliance on empirically derived, high-precision weighted capitation formulas for resource allocation.
- To argue that the pursuit of equity through such formulas is problematic due to measurement challenges.
Main Methods:
- The paper presents a critical analysis of the weighted capitation formula methodology.
- It discusses the limitations of using hospital utilization and social deprivation measures.
Main Results:
- The search for precise, empirically based resource allocation formulas is deemed largely fruitless.
- Measuring true healthcare need and costs accurately is impossible with current data limitations.
Conclusions:
- The inclusion of social deprivation measures in formulas is poorly conceived.
- Resource allocation formula impacts must be justifiable on grounds independent of their specific composition.