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Definition
Scenario 1
Scenario 2
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Unlike other issues in health care presented in this site, resource allocation does not seem to present two clear sides. Resource allocation is basically the debate between who should get what kind of care when. In this age of cost containment and reform, we cannot promise complete care to all who ask. Because of the subjective nature of this issue, specific scenarios will be presented instead of the traditional pro-con stances. Hopefully, these scenarios will give you a complete picture of the dilema of medical resource allocation. The scenarios are not meant to represent any actual events.
A 10-year-old girl has a rare disease that requires that she get huge blood transfusions on a weekly basis. She is placing a strain on the hospital's supply of her blood type. One day, during one of her regular transfusions, someone is brought into the emergency room bleeding profusely. The bleeder mactches the blood type of the girl. Both cannot be supplied with blood simultaneously as the hospital's supply is limited. Should the hospital discontinue supplying blood to the chronically ill girl, or should the hospital maintain its promise of care to her and transfer the emergent patient?
This scenario brings to mind the resource allocation issue of emergent versus chronic care. Which one should have the upper hand in the case of limited resources?
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Another scenario that involves consideration of resource allocation is critical care. Understandably ICU beds cost more per night to maintain than most other hospital beds. ICU patients recieve more attention and more medication, supplanted with hi-tech monitoring. Adult medical intensive care units (MICU's) are often occupied by elderly patients in the final stages of chronic illnesses. Neonatal ICU's, however, are reserved for premature infants that need critical care in the first few days of life. The question of resource allocation might come into play if finite resources of a hospital MICU are pitted against the needs of it's NICU. Because they both consume relatively large amounts of hospital resources, both are often targeted for reallocation practices.
Studies conducted at the University of Chicago have examined the amount of resources dedicated to patients in both MICU's and NICU's. Both studies exmined the mortality rates of patients in relation to the amount of care they received. The studies demonstrated that NICU patients usually do better than those in the MICU. Hence, they concluded that NICU's should be given resource allocation priorities over MICU's.
This example serves as a model for similar issues of allocation. Obviously, certain metrics need to be developed that aid practitioners and administrators in fairly dividing limited resources.