Aversion to health inequalities in healthcare prioritisation: a multicriteria optimisation perspective

Abstract

In this paper we discuss the prioritisation of healthcare projects where there is a concern about health inequalities, but the decision maker is reluctant to make explicit quantitative value judgements and the data systems only allow the measurement of health at an aggregate level. Our analysis begins with a standard welfare economic model of healthcare resource allocation. We show how - under the assumption that the healthcare projects under consideration have a small impact on individual health--the problem can be reformulated as one of finding a particular subset of the class of efficient solutions to an implied multicriteria optimisation problem. Algorithms for finding such solutions are readily available, and we demonstrate our approach through a worked example of treatment for clinical depression.

Keywords: Health inequalities; Healthcare prioritisation; Healthcare resource allocation; Mathematical programming; Multicriteria decision analysis (MCDA).