Rationing healthcare in New Zealand: the use of clinical guidelines

Med J Aust. 2000 Oct 16;173(8):423-6. doi: 10.5694/j.1326-5377.2000.tb139273.x.


A 1991 "Green and White Paper", Your health and the public health. A statement of government health policy, advised that healthcare services in New Zealand could be rationed by a simple list. The Health and Disability Services Act 1993 provided a framework for resource allocation. The Core Services Committee rejected the "Oregon approach" of using a simple list to determine what condition/treatment pairs should be funded, preferring the development of clinical guidelines as a basis for assessment. Clinical priority assessment criteria derived from guidelines are used to define the degree of clinical benefit for public funding. Criteria have been developed for entry into end-stage renal failure programs, access to coronary artery surgery, and entry into booking systems for other elective services. The development of clinical criteria to define access to services has had a difficult road, but is a start in defining public expectations of New Zealand's healthcare system.

MeSH terms

  • Appointments and Schedules
  • Cataract Extraction
  • Coronary Artery Bypass
  • Eligibility Determination / methods*
  • Health Care Costs
  • Health Care Rationing / economics
  • Health Care Rationing / legislation & jurisprudence
  • Health Care Rationing / standards*
  • Health Priorities*
  • Humans
  • Male
  • Middle Aged
  • New Zealand
  • Practice Guidelines as Topic*
  • Renal Dialysis
  • State Medicine / economics*