Making Choices for Healthcare PDF

Preface

Funding pressures have forced many countries to find ways of setting priorities in health care. The process is replete with difficulties and various methods have been tried. Recognizing that there is much to be learned from sharing experience, Sweden has taken the initiative in sponsoring two international seminars.

The first was held in Stockholm in October 1993, and the major findings were published in book form (Honigsbaum F, Calitorp J, Ham C, Holmstrom S (1995) Priority Setting Processes for Healthcare. Radcliffe Medical Press, Oxford). A second was held in Birmingham in May 1995, and this study is based on the data supplied there.

Five countries participated in the first seminar and a sixth was added for the second. They are: the USA (Oregon), New Zealand, The Netherlands, Norway. Sweden and the United Kingdom. Contributors came from all six countries and their names are listed on pages vii-viii. They supplied the papers on which the seminar was based.

The seminar was held over two days at the Health Services Management Centre, University of Birmingham. The first day consisted of a private seminar with participants from Sweden and the UK. The second day was open to a larger number of UK participants.

The seminar was sponsored by the Health Services Management Centre in collaboration with the Nordic School of Public Health and Bure Health Care. Professor Chris Ham is Director of the Centre, and he organized the meeting together with Professor Johan Calltorp and Dr Stefan Holmstrom from Sweden. Frank Honigsbaum, a Senior Research Fellow at the Centre, acted as rapporteur, and this report was prepared by him. Thanks are due to Glaxo Wellcome and the Stockholm County Council for help in financing the seminar and to Bure Health Care for help in financing publication of this book.

It is presented in two parts: the first describes the way in which processes have developed in the six countries, with emphasis on the changes which have occurred since the first seminar. The section dealing with Oregon draws not only on the paper submitted by Dr Castanares but on information obtained by Dr Stefan Holmstrom and Frank Honigsbaum during a visit to the US in the autumn of 1994. It also takes account of recent changes in the Oregon plan as indicated by Paige Sipes-Metzler, the Executive Director of the Oregon Health Services Commission. She and the contributors to the seminar have read the sections pertaining to them and kindly suggested changes and additions. Additional help was provided by Chris Ham, who reviewed the work as a whole and suggested ways in which it could be improved. His aid was invaluable.

The second part identifies the major trends that are evident and discusses the issues arising from them. References to publications and papers relevant to the seminar are listed at the end on pages I 17-123.

This report is based on data and views expressed at seminar proceedings but particularly in the second part, it also draws on interpretative judgements made by the rapporteur. For those, he is solely responsible

Authors: Frank Honigsbaum, Stefan Holmstrom, Johann Calltorp