What makes a health system good? From cost-effectiveness analysis to ethical improvement in health systems
Bibliographic Data
| ID | 21702467 |
|---|---|
| Authors | James Wilson (0009-0008-9401-7036, University College London, corresponding author) |
| Year | 2023 |
| Volume | 26 |
| Issue | 3 |
| Pages | 351-365 |
| Publication date | 2023-09-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Medicine Health Care and Philosophy (JOURNAL) |
| Journal identifiers | ISSN: 1386-7423 • E-ISSN: 1572-8633 |
| Publisher | Springer Science and Business Media LLC (PUBLISHER) |
| DOI | 10.1007/s11019-023-10149-9 |
| PMID | 37171746 |
| OpenAlex | W4376225642 |
| Language | EN |
| References cited | 28 |
Fair allocation of scarce healthcare resources has been much studied within philosophy and bioethics, but analysis has focused on a narrow range of cases. The Covid-19 pandemic provided significant new challenges, making powerfully visible the extent to which health systems can be fragile, and how scarcities within crucial elements of interlinked care pathways can lead to cascading failures. Health system resilience, while previously a key topic in global health, can now be seen to be a vital concern in high-income countries too. Unfortunately, mainstream philosophical approaches to the ethics of rationing and prioritisation provide little guidance for these new problems of scarcity. Indeed, the cascading failures were arguably exacerbated by earlier attempts to make health systems leaner and more efficient. This paper argues that health systems should move from simple and atomistic approaches to measuring effectiveness to approaches that are holistic both in focusing on performance at the level of the health system as a whole, and also in incorporating a wider range of ethical concerns in thinking about what makes a health system good
Alternative medicine · Engineering ethics · Epistemology · Health economics · Management science · Medical law · Pathology · Philosophy of biology · Philosophy of medicine · Philosophy of science · Psychiatry · Public health · Engineering · Health Systems, Economic Evaluations, Quality of Life · Healthcare cost, quality, practices · Healthcare Policy and Management · Medicine · Nursing · Philosophy
How Should We Aggregate Competing Claims?
After Virtue
A Theory of Justice
Well-Being and Pluralism
First Come, First Served
Four Unsolved Rationing Problems A Challenge
Professional Integrity and Physician-Assisted Death
Understanding the problem of long-term treatment adherence
The internal morality of medicine
Limits to Health Care
Understanding and misunderstanding randomized controlled trials
| Citation velocity | historical |
|---|---|
| Highly cited | No |