Abstract
We argue that Canadian provincial governments should contain medical care spending in order to invest more in the social determinants of health (SDH). Others have said this, many times. Doing it has not proven easy. We therefore emphasize the potential contribution of the priority-setting and resource allocation literature. This literature identifies formal tools and approaches that have built cultures of support for resource shifts, while providing pragmatic means for advancing efficiency and equity. Although reallocation towards SDH from other areas of the health care system is financially viable and supported by existing research, it will require new emphasis on the design of population health interventions that make reallocation politically expedient.
Key Words: Priority setting, resource allocation, social determinants of health
Résumé
Nous soutenons que les gouvernements provinciaux du Canada devraient limiter les dépenses de soins médicaux afin d’investir davantage dans les déterminants sociaux de la santé (DSS). D’autres ont dit la même chose, à maintes reprises. Mettre ceci en pratique n’a pas été aisé. Nous insistons donc sur la contribution possible de la documentation sur l’établissement de priorités et l’allocation de ressources. Dans cette documentation, on répertorie les outils et les approches qui renforcent des cultures de soutien à la réorientation des ressources, tout en proposant des façons pragmatiques de favoriser l’efficience et l’équité. Bien que la réaffectation vers les DSS à partir d’autres éléments du système de soins de santé soit financièrement viable et étayée par la recherche existante, elle nécessitera une nouvelle insistance sur la conception d’interventions en santé des populations qui rendent une telle réaffectation politiquement rentable.
Mots Clés: établissement de priorités, allocation de ressources, déterminants sociaux de la santé
Footnotes
Conflict of Interest: None to declare.
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