Is Rationing an Option for Approaching Healthcare Services Provision? the Case of the Greek Cardiac Patients

By Fafaliou, Irene; Tzanalaridou, Euthalia et al. | International Advances in Economic Research, February 2010 | Go to article overview

Is Rationing an Option for Approaching Healthcare Services Provision? the Case of the Greek Cardiac Patients


Fafaliou, Irene, Tzanalaridou, Euthalia, Ballas, Apostolos, International Advances in Economic Research


Abstract This paper attempts to address some of the issues surrounding rationing of healthcare services, with application to Greece's delivery of cardiac services. To this end, first, we provide highlights of the current debate concerning rationing worldwide and critically discuss them. Following that, an empirical analysis of the way 'key' stakeholders perceive rationing issues in Greece, is performed. Findings indicate that rationing is a highly disputed approach, subject to individualistic interpretations and moral issues. At policy level, it becomes evident that rationing is a mixture rather than a single policy concern, depending on a complicated range of locally-based reconciliation made at various levels of interested parties. Hence, no universal formula exists to fit all countries' healthcare systems and further case-by-case research, is required.

Keywords Rationing decision * Priority setting * Healthcare * Health policy making * Greek cardiac stakeholders

Introduction

The Issue in Context

The rising cost of healthcare services combined with the ever increasing problems in public financing worldwide, have recently led to reconsideration of rationing as a convenient method for cost savings in healthcare delivery (OECD 2008). Despite the theoretical justification of such concerns, however, there is no consensus in the field concerning the way and the extent to which rationing impacts patients' care (see for e.g. Klein and Williams 2000).

In practical terms, though several countries across the globe, such as the U.K., Canada, Sweden, Holland, Denmark, Norway, New Zealand and Israel, have implicitly or explicitly applied rationing in healthcare delivery, no valid estimation has been reached so far concerning the impact of such measures (Sabik and Lie 2008). Differences in outcomes are often discussed in the literature as reflecting differences in rationing perceptions, the methods employed and assumptions involved, as well as what rationing entails.

According to Cooper (1995), though 'rationing', 'cost containment' and 'priority setting' are not identical terms, they all finally address the same issues: 'how much of a certain healthcare service will be provided', 'to whom', 'at what cost' and 'under what circumstances'. For New (1996), rationing can be defined in terms of methods used. These are, namely: (a) the exclusion or denial of a service and (b) the withholding of a potentially beneficial treatment, without the patient's consent. In line with New, Mechanic (1997), points out the abundance of rationing tactics that can be used to implicitly control costs and determine whether a service delivery is required. These are, the following: queuing, reducing the intensity of services, and substituting less expensive for more costly services. All in all, it seems that there is a lack of a common understanding of 'who makes the decisions (or instructions) to the healthcare providers', 'how patients feel about rationing' and, most significantly, 'what is the effect on patients' care'.

The existing confusion in the field as well as the small number of locally-based surveys in micro environments constitute a great challenge for the authors of this paper to investigate the issue further, with application to a Greek context for the first time in Greece's Healthcare history. Our scope is not to generalize outcomes to a wider population but to enrich the existing theoretical knowledge (Mason 2002) by bringing into sight the awareness, attitudes, views and experience of a sample of Greek stakeholders, on major rationing issues.

This paper attempts to address some of the limitations of the existing work by providing a better understanding of the way locally-based stakeholders perceive rationing and its characteristics, as well as the impact of alternative rationing methods on patients' care. To this end, first, we open up a discussion concerning a few core and complex themes involved in rationing debate and, then, we perform an empirical case study analysis to explore Greece's delivery of cardiac services. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Is Rationing an Option for Approaching Healthcare Services Provision? the Case of the Greek Cardiac Patients
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.