How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.

The question of how to allocate scarce medical resources has become an important public policy issue in recent decades. Cost-utility analysis is the most commonly used method for determining the allocation of these resources, but this book counters the argument that overcoming its inherent imbalances is simply a question of implementing methodological changes. The Economics of Resource Allocation in Health Care represents the first comprehensive analysis of equity weighting in health care resource allocation that offers a fundamental critique of its basic framework. It offers a critique of health economics, putting the discourse on economic evaluation into its broader socio-political context. Such an approach broadens the debate on fairness in health economics and ties it in with deeper-rooted problems in moral philosophy. Ultimately, this interdisciplinary study calls for the adoption of a fundamentally different paradigm to address the distribution of scarce medical resources. This book will be of interest to policy makers, health care professionals, and post-graduate students looking to broaden their understanding of the economics of the health care system.

In ALLOCATING HEALTH CARE RESOURCES, leading authorities and researchers expose the basic philosophical, ethical, and economic issues underlying the current health care debate. The contributors wrestle with such complicated issues as whether it is ethical to ration health care, the morality of the worldwide bias against children in allocating health care resources, whether sin taxes can be defended morally, and how to achieve a just health care system. The book also includes an insightful analysis of the Clinton health care reform plan. ALLOCATING HEALTH CARE RESOURCES will be of interest to philosophers, health policy experts, medical ethicists, health professionals, and concerned citizens. It serves to clarify and illuminate the logic and rhetoric of health care reform, and so to help us all achieve a fair and equitable distribution of these precious resources.

The competition for limited health care resources is intensifying. We urgently need an acceptable method for deciding how they should be allocated. The Quality-Adjusted Life Year, or QALY, is the most developed proposal for such allocation. In this book a distinguished team of ethicists and economists defend the core of the QALY proposal: that health care resources should be used so as to produce more years of life, of the highest possible quality. The result is the most thorough account yet of the ethical issues raised by the use of the QALY as a basis for allocating health care resources.

This book has two major objectives. The first is to propose the Health Resource Allocation Strategy as a social and political process for comparing costs and outcomes of alternative policy options in the health and medical care arena to select interventions with greatest benefit in relation to cost. The second objective is to provide a reference for state-ofthe-art development and application of health status and quality of life measures for health care policy and research, including clinical applications. Not all policy applications of health- related quality of life involve resource allocation. Thus we present guidelines to assessment for use in program evaluation, monitoring of health policy, clinical trials, and health services research.

Budgets of governments and private insurances are limited. Not all drugs and services that appear beneficial to patients or physicians can be covered. Is there a core set of benefits that everyone should be entitled to? If so, how should this set be determined? Are fair decisions just impossible, if we know from the outset than not all needs can be met? While early work in bioethics has focused on clinical issues and a narrow set of principles, in recent years there has been a marked shift towards addressing broader population-level issues, requiring consideration of more demanding theories in philosophy, political science, and economics. At the heart of bioethics' new orientation is the goal of clarity on a complex set of questions in rationing and resource allocation. Rationing and Resource Allocation in Healthcare: Essential Readings provides key excerpts from seminal and pertinent texts and case studies about these topics, contextualized by original introductions. The volume is divided into three broad sections: Conceptual Distinctions and Ethical Theory; Rationing; and Resource Allocation. Containing the most important and classic articles surrounding the theoretical and practical issues related to rationing and how to allocate scare medical resources, this collection aims to assist and inform those who wish to be a part of bioethics' 21st century shift including practitioners and policy-makers, and students and scholars in the health sciences, philosophy, law, and medical ethics.

This Open Access book highlights the ethical issues and dilemmas that arise in the practice of public health. It is also a tool to support instruction, debate, and dialogue regarding public health ethics. Although the practice of public health has always included consideration of ethical issues, the field of public health ethics as a discipline is a relatively new and emerging area. There are few practical training resources for public health practitioners, especially resources which include discussion of realistic cases which are likely to arise in the practice of public health. This work discusses these issues on a case to case basis and helps create awareness and understanding of the ethics of public health care. The main audience for the casebook is public health practitioners, including front-line workers, field epidemiology trainers and trainees, managers, planners, and decision makers who have an interest in learning about how to integrate ethical analysis into their day to day public health practice. The casebook is also useful to schools of public health and public health students as well as to academic ethicists who can use the book to teach public health ethics and distinguish it from clinical and research ethics.