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© 1992 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom

research-article

Rationality and the use of formulae in the allocation of resources to health care


Roy Carr-Hill, Senior Research Fellow in Medical Statistics
Trevor Sheldon, Lecturer in Medical Statistics

Centre for Health Economics, University of York York YO1 5DD
Department of Public Health Medicine, University of Leeds 30 Hyde Terrace, Leeds LS2 9LN

The paper describes how the apparent move towards rationality in allocating resources in the National Health Service using statistically based formulae is illusory. This is not just a technical problem of poor application of statistical techniques. The basic problem is to find a combination of factors reflecting dimensions of need and then appropriate weights with which to combine them within the context of the guiding principles of equity and efficiency. The paper explains how there has been little consistency in measuring need and how statistical methods have often masked the lack of appropriate data and models. Alternative approaches to measuring need within a policy context are discussed and a research agenda is outlined which, rather than concentrating on evermore complex statistical techniques, focuses on the necessity for more validly operationalizing ‘needs’ and their resource implications.


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