A time-neutral perspective on severity to support fair and consistent priority setting in healthcare
Healthcare systems often face tough decisions about how to allocate limited resources fairly. One central factor for such decisions in needs-based systems is severity. To help make resource allocation decisions in healthcare systems fairer and more consistent, a new publication suggest to assess the severity of a condition from a time-neutral perspective.
Niklas Juth, co-author of the study.
There is a need to develop robust foundations for making fair allocation decisions in healthcare. For instance, it has been unclear how severity should relate to temporality, and there is a rich discussion on temporality and distributive justice. The authors of an article published in the journal Health Care Analysis argue that this discussion needs to be adapted to the practical and ethical requirements of healthcare priority setting principles.
“When assessing the severity of a condition, we should look at complete conditions from a time-neutral perspective, meaning that we take the full affectable stretch of the condition into account without modifying severity as patients move through the temporal stretch and without discounting the future,” says Niklas Juth, Professor of Medical Ethics, Research Leader at the Centre for Research Ethics & Bioethics at Uppsala University, and co-author of the study.
The authors argue that one should not take into account whether the severity has a declining or inclining curve, or that severity is intermittent rather than continuous, the authors argue. Also, small differences in severity matter. Every measurable difference in severity should matter when making decisions about who gets priority in healthcare.
This approach is readily usable in actual priority setting, according to the authors. By focusing on conditions, instead of individuals, this quantified approach ensures that all measurable differences in severity are factored into cost-effectiveness decisions, supporting fairer and more consistent priority setting in healthcare.
Do you want to know more? Read the article: Sandman, L., Juth, N. Severity and Temporality in Healthcare Priority Setting – A Case for A Condition-specific Affectable Time-neutral Approach. Health Care Analysis (2024). DOI: 10.1007/s10728-024-00493-z
By Fanny Klingvall