This paper argues that the Quality Adjusted Life Year or QALY is fatally flawed as a way of priority setting in health care and of dealing with the problem of scarce resources. In addition to showing why this is so the paper sets out a view of the moral constraints that govern the allocation of health resources and suggests reasons for a new attitude to the health budget.

Operations research (OR) is concerned with scientifically deciding how to best design and operate people–machine systems, usually under conditions requiring the allocation of scarce resources. This publication, one of a series, is offered to supervisors, lead people, middle managers, and anyone who has responsibility for operations planning in manufacturing facilities or corporate planning over...

Liver transplantation has undergone a rapid evolution from a high-risk experimental procedure to a mainstream therapy for thousands of patients with a wide range of hepatic diseases. Its increasing success has been accompanied by progressive imbalance between organ donor supply and the patients who might benefit. Where demand outstrips supply in transplantation, a system of organ allocation is ...

Biologic drugs have provided excellent results in the treatment of moderate to severe psoriasis. Nevertheless, in routine clinical practice, combinations of biologic drugs with phototherapy or systemic drugs can increase efficacy, diminish toxicity, and reduce the cost of treatment. Published experience with these combinations is scarce, although the results are often satisfactory. This review ...

Abstract Spectrum has now become a scarce resource due to the continuous development of wireless communication technology. Cognitive radio technology is considered be new method solve shortage spectrum resources. The allocation model cognitive can effectively avoid waste A novel binary version slime mould algorithm proposed for scheme. In addition, adding unselected factors strategy make approa...

water markets are instrumental in efficient allocation and pricing of scarce water by enhancing allocative and price efficiency of water use. the prerequisites for water market formation are tradable water rights independent from ownership of the land, extensive water canals, water use associations, and adequate market regulations. mojen water market has been facilitating exchange of alternativ...

Coronary artery disease complicates only 0.01% of all pregnancies. For this reason, more exhaustive data on the management of such cases is lacking. Even guidelines on management of cardiovascular disease in pregnant women are scarce focusing mainly on acute myocardial infarction. This is a complex issue involving thorough evaluation of cardiovascular status in each pregnant woman, assessment o...

The first sentence of Leo Tolstoy’s (1875–1877/2001) novel Anna Karenina is: “Happy families are all alike; every unhappy family is unhappy in its own way.” Here, Tolstoy means that for a family to be happy, several key aspects must be given (e.g., good health of all family members, acceptable financial security, and mutual affection). If there is a deficiency in any one or more of these key as...