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“In austere financial times, which procedures should be rationed and who should decide?”. Jason Yuen. Final year medical student – University of Oxford Professor Harold Ellis Medical Student Prize for Surgery 23 rd November 2012. 1) Tough financial conditions. 3) New, expensive treatments.
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“In austere financial times, which procedures should be rationed and who should decide?” Jason Yuen Final year medical student – University of Oxford Professor Harold Ellis Medical Student Prize for Surgery 23rd November 2012
1) Tough financial conditions 3) New, expensive treatments 2) Ageing population
Clinical Ethical Economic
Clinical aspect Benefits of surgery Risks of surgery
Benefits of surgery • QALY?
Also consider • Local expertise • Alternatives
Ethics • Still “meet the needs of everyone”? • No but we need to consider how to distribute the resources fairly and “based on clinical need, not ability to pay”
Take home message • Rationing is inevitable • In order to prioritise procedures, factors to consider – clinical, economic, ethical • Problems in balancing these • Systematic and fair approach • The stakeholders
Any questions? 'You need an urgent operation. But not to worry, I'll make sure you're on my list.'