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. 1986 Feb 15;134(4):333–340.

Allocation of health care resources: a challenge for the medical profession.

D Naylor, A L Linton
PMCID: PMC1490802  PMID: 3080215

Abstract

If current limitations on health care funding continue, medical practitioners will face increasing pressure to conserve scarce resources and to participate in the allocation of funds. This article discusses the ethical and economic aspects of the physician's role and briefly reviews some efficiency measures that might mitigate the effects of rationing of health care services.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baltzan M. A. Medical care costs related to physician manpower - a new economic theory. Can Med Assoc J. 1973 Jan 6;108(1):101–106. [PMC free article] [PubMed] [Google Scholar]
  2. Berlyne G. M. Over 50 and uremic equals death. The failure of the British National Health Service to provide adequate dialysis facilities. Nephron. 1982;31(3):189–190. doi: 10.1159/000182644. [DOI] [PubMed] [Google Scholar]
  3. Blendon R. J., Altman D. E. Public attitudes about health-care costs. A lesson in national schizophrenia. N Engl J Med. 1984 Aug 30;311(9):613–616. doi: 10.1056/NEJM198408303110938. [DOI] [PubMed] [Google Scholar]
  4. Brook R. H., Ware J. E., Jr, Rogers W. H., Keeler E. B., Davies A. R., Donald C. A., Goldberg G. A., Lohr K. N., Masthay P. C., Newhouse J. P. Does free care improve adults' health? Results from a randomized controlled trial. N Engl J Med. 1983 Dec 8;309(23):1426–1434. doi: 10.1056/NEJM198312083092305. [DOI] [PubMed] [Google Scholar]
  5. Detsky A. S., Stacey S. R., Bombardier C. The effectiveness of a regulatory strategy in containing hospital costs. The Ontario experience, 1967-1981. N Engl J Med. 1983 Jul 21;309(3):151–159. doi: 10.1056/NEJM198307213090306. [DOI] [PubMed] [Google Scholar]
  6. Enterline P. E., Salter V., McDonald A. D., McDonald J. C. The distribution of medical services before and after "free" medical care--the Quebec experience. N Engl J Med. 1973 Nov 29;289(22):1174–1178. doi: 10.1056/NEJM197311292892206. [DOI] [PubMed] [Google Scholar]
  7. Everett G. D., deBlois C. S., Chang P. F., Holets T. Effect of cost education, cost audits, and faculty chart review on the use of laboratory services. Arch Intern Med. 1983 May;143(5):942–944. [PubMed] [Google Scholar]
  8. Fein R. Effects of cost sharing in health insurance. A call for caution. N Engl J Med. 1981 Dec 17;305(25):1526–1528. doi: 10.1056/NEJM198112173052510. [DOI] [PubMed] [Google Scholar]
  9. Hiatt H. H. Lessons of the coronary-bypass debate. N Engl J Med. 1977 Dec 29;297(26):1462–1464. doi: 10.1056/NEJM197712292972611. [DOI] [PubMed] [Google Scholar]
  10. Levey S., Hesse D. D. Bottom-line health care? N Engl J Med. 1985 Mar 7;312(10):644–647. doi: 10.1056/NEJM198503073121009. [DOI] [PubMed] [Google Scholar]
  11. Lister J. By the London post. Cash limits and the rebels of Lambeth-Private medicine for Trade Unionists--Postscript on a plaque of greenfly. N Engl J Med. 1979 Nov 1;301(18):984–986. doi: 10.1056/NEJM197911013011807. [DOI] [PubMed] [Google Scholar]
  12. Luft H. S., Bunker J. P., Enthoven A. C. Should operations be regionalized? The empirical relation between surgical volume and mortality. N Engl J Med. 1979 Dec 20;301(25):1364–1369. doi: 10.1056/NEJM197912203012503. [DOI] [PubMed] [Google Scholar]
  13. Manning W. G., Leibowitz A., Goldberg G. A., Rogers W. H., Newhouse J. P. A controlled trial of the effect of a prepaid group practice on use of services. N Engl J Med. 1984 Jun 7;310(23):1505–1510. doi: 10.1056/NEJM198406073102305. [DOI] [PubMed] [Google Scholar]
  14. McDonald A. D., McDonald J. C., Salter V., Enterline P. E. Effects of Qubec Medicare on physician consultation for selected symptoms. N Engl J Med. 1974 Sep 26;291(13):649–652. doi: 10.1056/NEJM197409262911304. [DOI] [PubMed] [Google Scholar]
  15. Mechanic D. Approaches to controlling the costs of medical care: short-range and long-range alternatives. N Engl J Med. 1978 Feb 2;298(5):249–254. doi: 10.1056/NEJM197802022980505. [DOI] [PubMed] [Google Scholar]
  16. Moloney T. W., Rogers D. E. Medical technology -- a different view of the contentious debate over costs. N Engl J Med. 1979 Dec 27;301(26):1413–1419. doi: 10.1056/NEJM197912273012603. [DOI] [PubMed] [Google Scholar]
  17. O'Grady K. F., Manning W. G., Newhouse J. P., Brook R. H. The impact of cost sharing on emergency department use. N Engl J Med. 1985 Aug 22;313(8):484–490. doi: 10.1056/NEJM198508223130806. [DOI] [PubMed] [Google Scholar]
  18. Oreopoulos D. G. Should we let them die? The moral dilemmas of economic restraints on life-support treatments. Can Med Assoc J. 1982 Apr 1;126(7):745–746. [PMC free article] [PubMed] [Google Scholar]
  19. Petersdorf R. G. Is the establishment defensible? N Engl J Med. 1983 Oct 27;309(17):1053–1057. doi: 10.1056/NEJM198310273091711. [DOI] [PubMed] [Google Scholar]
  20. Relman A. S. The Rand health insurance study: is cost sharing dangerous to your health? N Engl J Med. 1983 Dec 8;309(23):1453–1453. doi: 10.1056/NEJM198312083092310. [DOI] [PubMed] [Google Scholar]
  21. Roemer M. I., Roemer J. E. The social consequences of free trade in health care: a public health response to orthodox economics. Int J Health Serv. 1982;12(1):111–129. doi: 10.2190/1EY0-GNUG-7HT1-WLB1. [DOI] [PubMed] [Google Scholar]
  22. Schwartz H. Conflicts of interest in fee for service and in HMO's. N Engl J Med. 1978 Nov 9;299(19):1071–1073. doi: 10.1056/NEJM197811092991913. [DOI] [PubMed] [Google Scholar]
  23. Schwartz W. B., Aaron H. J. Rationing hospital care. Lessons from Britain. N Engl J Med. 1984 Jan 5;310(1):52–56. doi: 10.1056/nejm198401053100120. [DOI] [PubMed] [Google Scholar]
  24. Schwartz W. B., Joskow P. L. Duplicated hospital facilities: How much can we save by consolidating them? N Engl J Med. 1980 Dec 18;303(25):1449–1457. doi: 10.1056/NEJM198012183032504. [DOI] [PubMed] [Google Scholar]
  25. Schwartz W. B., Joskow P. L. Sounding Board. Medical efficacy versus economic efficiency: a conflict in values. N Engl J Med. 1978 Dec 28;299(26):1462–1464. doi: 10.1056/NEJM197812282992612. [DOI] [PubMed] [Google Scholar]
  26. Somers A. R. Why not try preventing illness as a way of controlling Medicare costs? N Engl J Med. 1984 Sep 27;311(13):853–856. doi: 10.1056/NEJM198409273111312. [DOI] [PubMed] [Google Scholar]
  27. Thomas L. Notes of a biology-watcher. On magic in medicine. N Engl J Med. 1978 Aug 31;299(9):461–463. doi: 10.1056/NEJM197808312990908. [DOI] [PubMed] [Google Scholar]
  28. Thurow L. C. Learning to say "no". N Engl J Med. 1984 Dec 13;311(24):1569–1572. doi: 10.1056/NEJM198412133112410. [DOI] [PubMed] [Google Scholar]
  29. Vayda E. A comparison of surgical rates in Canada and in England and Wales. N Engl J Med. 1973 Dec 6;289(23):1224–1229. doi: 10.1056/NEJM197312062892305. [DOI] [PubMed] [Google Scholar]
  30. Vladeck B. C. Medicare hospital payment by diagnosis-related groups. Ann Intern Med. 1984 Apr;100(4):576–591. doi: 10.7326/0003-4819-100-4-576. [DOI] [PubMed] [Google Scholar]

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