EUnetHTA Adaptation Glossary (beta)

For this term I cannot figure many conflicts or misunderstanding in its use. To my knowledge it is predominantly used according to existing definitions. Sometimes it might be confused with “equality” or with “justice”. To my knowledge most of HTA-reports to date did not deal with “Equity” at least formally or in a systematic way.

Issue

Equity, together with efficiency are two of the main driving principles in health care planning and provision of care in publicly financed health care systems. The concept of equity is a complex concept, but most would agree with the definition of “equal access to equal treatment for people with similar level of need”. One of the main objectives of the policy makers is to reach the adequate balance between equity and efficiency.

Relevance and dimensions of equity in HTA

Equity has a relevant role in different stages of HTA:

The idea of equity in health services must be seen in close relation to the principles of justice, fairness and non-discrimination. Equity can refer to both the level of health care provide and the access to health care. Equity therefore can be outcome or “opportunity” oriented. Equity also requires health literacy as health care users must be empowered to use health care system. From an individual point of view, equity describes what the individual reasonably can expect from a solitary health care system.

The Norwegian Knowledge Centre has paid little attention to the issue of equity in our work in general and in the use of external HTA reports and reviews in particular. Our responsibility for an international conference on the issue of equity in 2006 [3] has, however, raised our awareness of this issue. The conference also led to a publication that serves as background for advice from the WHO Advisory Committee on Health Research [4]. Here, the authors give recommendations of how issues of equity should be addressed in the development of systematic reviews and guidelines.

Within an HTA project equity can be defined as fairness when allocating resources and interventions among individuals or groups. Equity issues are important both in relation to needs and access to services. Equity as an ethical imperative has to be taken into account when organizing health care systems, setting goals, and allocating health care resources.

Fairness in the allocation of resources or treatments among different individuals or groups.