Prioritising health services in an era of limits: The Oregon experience

J. A. Kitzhaber

doi:10.1136/bmj.307.6900.373

Prioritising health services in an era of limits: The Oregon experience

J. A. Kitzhaber

Research output: Contribution to journal › Article › peer-review

81 Scopus citations

Abstract

How do we decide who should receive the benefits that medical science has to offer? One approach to this decision process, that used by the state of Oregon, is described: who and what are covered, and how health care is financed and delivered, are considered. Oregon's priorities were set on the basis of broad consensus. The objective of health care reform, it was agreed, is to improve, maintain, or restore health - not universal coverage, access to health care, or cost containment. A Health Services Commission was created to consider clinical effectiveness and, through public involvement, to attempt to integrate social values into the priority list. Oregon's legislature can use the list to develop an overall health policy which recognises that health can be maintained only if investments in several related areas are balanced.

Original language	English (US)
Pages (from-to)	373-377
Number of pages	5
Journal	British medical journal
Volume	307
Issue number	6900
DOIs	https://doi.org/10.1136/bmj.307.6900.373
State	Published - 1993
Externally published	Yes

Funding

Results ofconsensus Although viewed as controversial outside the state, the plan was enacted with broad based support. It was not achieved through confrontation nor by trying to find villains and scapegoats. Rather, it represents a consensus building exercise that was supported by the Oregon Medical Association, the Association of Oregon Hospitals, consumer groups, organised labour, and the business community. It passed both houses of the Oregon legislature with huge majorities in both parties.

Funders
American Heart Association/American Stroke Association
Oregon Association for Hospitals and Health Systems
Oregon Medical Association

ASJC Scopus subject areas

General Medicine

Access to Document

10.1136/bmj.307.6900.373

Cite this

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abstract = "How do we decide who should receive the benefits that medical science has to offer? One approach to this decision process, that used by the state of Oregon, is described: who and what are covered, and how health care is financed and delivered, are considered. Oregon's priorities were set on the basis of broad consensus. The objective of health care reform, it was agreed, is to improve, maintain, or restore health - not universal coverage, access to health care, or cost containment. A Health Services Commission was created to consider clinical effectiveness and, through public involvement, to attempt to integrate social values into the priority list. Oregon's legislature can use the list to develop an overall health policy which recognises that health can be maintained only if investments in several related areas are balanced.",

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Prioritising health services in an era of limits: The Oregon experience

Abstract

Funding

ASJC Scopus subject areas

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