Stephen Jan

Examining preferences for allocating health care gains

This study is part of a programme to elicit and examine community preferences for health care in different contexts. Data were obtained from a group of predominantly Australian health care decision-makers. A short questionnaire contained six valuation questions and four demographic questions. The six valuation questions posed choices where equal health gains were to be allocated to different population groups based upon: age; sex; current health; socio-economic status; across time; and across different numbers of individuals. The results provide some evidence that respondents were prepared to discriminate between health gains derived in different contexts especially where health gains were to be allocated between groups of different health status and over time. Further research is planned and the possible implications for health policy, and in particular for resource allocation in health care, are briefly discussed.

Efficiency considerations in the expansion of radiation therapy services

PURPOSE An economic option appraisal to determine whether early investment in capital is an efficient means of expanding radiation therapy services. METHODS AND MATERIALS Costs were based on 1991 data from a center in western Sydney. Two options were costed: Option 1 based on an increase in overtime performed by existing staff, using capital more intensively and possible use of shifts; Option 2 based on an investment in new capital and associated increases in levels of staffing. The health sector costs of both options were determined in one center at workloads of between 70,940 and 98,525 fields per year to assess relative efficiency. RESULTS There was very little difference in cost between both options, with Option 1 slightly cheaper at workloads up to 98,525 fields per year. CONCLUSIONS The results suggest that capital investment may be introduced at a fairly early stage without efficiency loss. Sensitivity analysis reinforces these conclusions and the generalizability of the results.