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33 - Priority setting

Published online by Cambridge University Press:  30 October 2009

Douglas K. Martin
Affiliation:
Associate Professor University of Toronto
Jennifer L. Gibson
Affiliation:
Assistant Professor University of Toronto
Peter A. Singer
Affiliation:
Professor University of Toronto
Peter A. Singer
Affiliation:
University of Toronto
A. M. Viens
Affiliation:
University of Oxford
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Summary

Dr. B is on the seventh day of his rotation as medical director of the intensive care unit (ICU) when he receives a referral call about a patient in emergency who needs ICU admission for ventilation support. Dr. B examines his ICU census and notes that not only are there no ICU beds available but there is also a request from a thoracic surgeon for an ICU bed for a patient currently in the observation room, and there is a request from a nearby hospital to transfer one of their patients to Dr. B's ICU.

Dr. C, a pediatrician, has been asked to chair her hospital drug formulary committee to examine new drugs and determine which ones should be provided from the hospital budget. She is aware that these decisions are complex and often controversial and is unsure how to proceed.

What is priority setting?

Priority setting involves deciding which resources to allocate to competing needs. It is a key component of every health system because, whether wealthy or poor, no system can afford to provide every service that it may wish to provide. Both publicly and privately funded systems have the challenge of delivering quality care within the limits of government budgets or enrollee and employer contributions.

Within health systems, priority setting occurs at each decision level: micro (at the bedside or in clinical programs), meso (in hospitals or regional institutions), and macro (at the system-wide level).

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Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2008

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