Two new CHE research papers
CHE's latest Research Papers 120 and 121 written by Tony Culyer
Efficiency, equity and equality in health and health care
Three common “Es” have high ethical and political content for health policy: efficiency, equity and equality. This paper examines the links between the three, with especial attention given to (a) the claimed conflict between efficiency and equity, (b) the equity of inequalities and (c) the conflict between six equity principles: equal health, equal health gain, equal value of additional health, maintaining existing distributions, allocation according to need and equal per capita resources.
Full Report:CHE Research Paper 120 (PDF , 1,596kb)
Cost-effectiveness thresholds in health care: a bookshelf guide to their meaning and use
This paper explains the essential meaning of a cost-effectiveness threshold, using the simple metaphor of a bookshelf. Implications of its use, misuse and non-use are explored. These matters are discussed in the context of decisions by governments and agencies concerning the inclusion or exclusion of healthcare technologies in public programmes. To keep matters simple, the assumptions made throughout are that insured persons have access to technologies free of charge and that the principal objective of such schemes is to promote population health. The assumption is maintained throughout that 'effectiveness' relates to the impact of an intervention on people’s health. This is not to deny that health care systems may have objectives other than health maximisation but to focus on what is undoubtedly a major objective. The analysis is considered in the context of countries of varying degrees of economic development but the main focus is on low- and middle-income countries considering how best to advance universal health coverage by introducing a public health insurance scheme.
Full Report:CHE Research Paper 121 (PDF , 1,785kb)
Other papers in the CHE Research paper series can be found at: CHE Research Papers