Rationing health care
Grimes, D.S.
Lancet 1(8533): 615-616
1987
ISSN/ISBN: 0140-6736 PMID: 2881143 Document Number: 300952
Grimes criticizes the use of quality adjusted life years (QALYs) to allocate funds within Britain's National Health Service. Developed by health economists at the University of York, the QALY system determines how many years of patient life, adjusted for quality, a given treatment is likely to generate. QALYs tend to favor younger patients and acute conditions, because the longer a patient survives after treatment (with a given quality of life), the better value for the money, and a single treatment is less expensive than continuing care. Because QALYs are intended to aid macroallocation decisions rather than to be applied to individual patients, additional factors must be taken into account when rationing care. Grimes concludes that neither physicians, administrators, economists, nor politicians are willing to face the problems of justly allocating resources among individual patients, and that this unwillingness is detrimental to the "poor, the weak, and the inarticulate."