Background: This is the first time that a resource allocation technique based on a marginal met need approach has been used in Portugal, and the objective of the study is to attain the improvement of allocative efficiency.
Methods: The utilities of health states with and without treatment have been measured using the rating scale technique and a cost-utility analysis has been made. The value resulting from multiplying the avoided days of incapacity by a weight, on a scale from zero to one, has been considered as an indicator of utility corresponding to the difference between a health state with and without treatment. This study has been carried out using the main causes of morbidity from the National Health Survey, 1987, at a regional level. A sample of 150 local authorities was considered to be sufficient. A second objective of this study was to carry out a cost-utility analysis for the main causes of declared morbidity.
Results: This analysis has shown that the ratio of cost-utility is highest for hypertension, followed by influenza, asthma and digestive ill-functioning. Pharyngitis-amygdalitis, cold, osteoarthrosis, chronic bronchitis, spondylous arthrosis and diabetes are the illnesses with a more favourable cost-utility ratio which, in a rational resource allocation, should be treated first.
Conclusions: So that an increase in the allocative efficiency could be achieved, a transfer of resources between regions is required up to the point at which the use of these resources would be equally efficient. Resources should be transferred from two regions - Interior Centre Region and Littoral Lisbon Region - towards all the other regions, in particular the Interior North Region.