Letters

New Zealand priority criteria project

BMJ 1997; 314 doi: http://dx.doi.org/10.1136/bmj.314.7087.1130a (Published 12 April 1997) Cite this as: BMJ 1997;314:1130

More use should be made of patient oriented quality of life measures

  1. Alan Mordue, Consultant in public health medicinea,
  2. David W Parkin, Senior lecturer in health economicsb
  1. a Borders Health Board, Melrose, Roxburghshire TD6 9DB
  2. b Department of Epidemiology and Public Health, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH
  3. c Department of Medicine, Christchurch School of Medicine, Christchurch Hospital, PO Box 4345, Christchurch, New Zealand

    Editor—The New Zealand priority criteria project is worthy of wide debate, and Britain has much to learn from it.1 2 Unlike the approach taken in Oregon, the project recognises that benefits from treatment depend on the selection of patients and the threshold for intervention, which is important in maximising the health gain from healthcare resources. The New Zealand approach also provides a mechanism for addressing equity based on need rather than on service measures such as waiting times and levels of activity.

    The criteria used in the project are a mix of symptoms, clinical signs, impairments, and disabilities. However, the symptoms and clinical signs (which are impairments themselves) account for most of the available 100 points, while disability as represented by the criterion “ability to work, care for dependants, or live independently” can score only 10-16 points maximum. This is explained by the fact that “a certain degree of misgiving was usually noted about incorporating these social factors” …

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