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Flashcards in ASBHDS - Session 1 Deck (37)
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What is the difference between explicit and implicit rationing?

Implicit - allocation of resources through individual clinical decisions without the criteria for decisions being explicit

Explicit - the use of institutional procedures for the systematic allocation of resources within a health care system


Give some disadvantages of implicit rationing

- can lead to inequities and discrimination
- open to abuse
- decisions based on perceptions of 'social deserving-ness'
- doctors increasingly unwilling to do it


Give some advantages of explicit rationing

- transparent and accountable
- opportunity for debate
- more clearly evidence-based
- more opportunities for equity in decision-making


Give some disadvantages of explicit rationing

- very complex
- heterogeneity of patients and illnesses makes it difficult
- patient/professional hostility
- impact on clinical freedom
- evidence of patient distress


What does NICE stand for?

National Institute for Health and Care Excellence


What is the purpose of NICE?

Enables evidence of clinical and cost effectiveness to be integrated to form a judgement on the value of a treatment


Why is the role of NICE in approving/rejecting expensive treatments sometimes seen as controversial?

- if not approved, patients effectively denied access to treatment
- if approved, NHS organisations must fund them, even if with adverse consequences for other priorities

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