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Unit 2: Project Analysis and Selection

Decisions at this level include: Who gets the next available heart for transplant? And, who sees Notes
the doctor first when there are many people waiting in an emergency room?

Did u know? Development of the Project Charter is a pivotal starting point for the project,
establishing the project definition that will serve as the foundation for all future efforts.

2.3 Why is Resource Allocation needed?

Because of increasing demand for healthcare services and rising costs to provide those services,
Americans must choose how to allocate healthcare dollars.

Rising Cost of Healthcare

Resources spent on healthcare have increased over the last century. Americans are spending far
more resources on healthcare than do citizens of any other industrialized nation. Why?
1. Continued medical advances have lead to more accurate diagnoses and better treatments,
but also have increased the cost of healthcare.
2. The aging population is growing. Nearly 36 million Americans (more than the entire
population of Canada) are age 65 or older and account for a majority of healthcare
expenditures.
3. More people are living with chronic disease and disabilities, including AIDS.

Healthcare Rationing

Rationing refers to the conscious decision to exclude certain people from a service or treatment
that they need. Rationing takes many forms. Rationing occurs when a state determines who is
eligible for Medical Assistance insurance. It also occurs when deciding which patient on the
waiting list gets an organ transplant. Rationing is also utilized when prices are set for health
insurance and health services that some people cannot afford.

Oregon Health Plan

Oregon has implemented an innovative health plan that rations health care by developing a
prioritized list of treatments. A cut off line is then set to determine which services would be
covered and which would not. The plan serves to increase access to health care for more Oregon
residents but cuts down on the range of services covered
This plan allows Oregon to provide health care access to a greater percentage of its residents, but
it raises a number of ethical considerations. If ranking health care services is based on improving
quality of life rather than medical or biological outcomes, how do we evaluate quality of life? Is
it ethical to refuse to medical care based on cost-effective rankings? Does the method of ranking
by quality of life discriminate against people with disabilities?

!
Caution Successful projects begin with a detailed project definition that is understood and
accepted by Stakeholders.

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