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Distributing medical resources

An application of cooperative bargaining theory to an allocation problem in medicine


Antje Köckeritz

Allocating scarce medical resources has become an important topic in public discussion. In the German statutory health system we are facing a situation of lacking adequate funds for all needs. The financial restrictions force us to use resources wisely. This emphasizes the need of general allocation rules and criteria applied in medical allocation situations. The purpose of this work is to implement and interpret properties of cooperative bargaining theory to special allocation situations in medicine. The author shows how the concepts of Nash and Kalai/Smorodinsky can be applied to a medical allocation problem and discusses implications of their properties and solutions for the German health system.


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Table of abbreviations


abbr. abbreviated AN Anonymity B.AN Anonymity in budget allocations B.CONT Continuity in budget allocations B.INV Invariance of budget transformation B.INV’ Invariance of budget transformation for n patients B.IRR Independence of irrelevant budget allocations B.MON Monotonicity in budgets B.SYM Symmetry in budget allocations B.WPO Weak Pareto optimality in allocating the budget B.WPO’ Weak Pareto optimality in allocating the budget for n patients BVA Bundesversicherungsamt C.MON Monotonicity in claims CONT Continuity DFG Deutsche Forschungsgemeinschaft EBM Einheitlicher Bewertungsmaßstab FOR 655 Forschergruppe 655 in der DFG G-BA Gemeinsamer Bundesausschuss G-DRG German diagnosis related groups GKV Gesetzliche Krankenversicherung InEK Institut für das Entgeltsystem im Krankenhaus INV Invariance under positive affine transformation IMON Individual monotonicity IQWiG Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen IRR Independence of irrelevant alternatives P.MON Monotonicity in number of patients PG.MON Monotonicity in number of patients groups POMON Population monotonicity QALYS Quality adjusted life years RMON Restricted monotonicity S.INV Invariance under positive affine transformation of success probabilities 14 S.WPO Weak Pareto optimality of chances of success S.SYM Symmetry of chances of success SGB V Sozialgesetzbuch V SYM Symmetry VKA Verband kommunaler Arbeitgeber WPO Weak Pareto optimality ZEKO Zentrale Ethikkommission

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