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Allocation of Scarce Resources During Mass Casualty Events
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Allocation of Scarce Resources icon 
What is the Allocation of Scarce Resources?

The “allocation of scarce resources” is the determination of how to equitably and fairly use scarce medical resources available in a contingency or crisis care environment. “Scarce resources” is defined as medical care resources that are likely to be scarce in a crisis care environment. Potential medical care resources that may become scarce during a disaster or emergency include physical items (e.g., medical supplies, drugs, beds, equipment), services (e.g., medical treatments, nursing care, palliative care), and health care personnel (e.g., physicians, nurses, psychologists, laboratory technicians, EMS providers, and other essential workers).

Depending on the scale of a disaster or emergency, a range of responses will be required from providers, health care institutions, regional coalitions, and public health agencies. The range of these responses will depend on the severity of the disaster or emergency. According to the Institute of Medicine (IOM), the response “…can be envisioned as occurring along a continuum based on resource availability and demand for health care services. One end of this continuum is defined by conventional responses—those services that are provided in health care facilities on a daily basis and are expanded for disaster planning and response. At the other end of the continuum is crisis care, when the best possible care is provided to the population of patients as a whole because of the very limited resources available. Significant changes are made in the methods and locations of care delivery, and decision-making shifts from patient-centered to population-centered outcomes” (Institute of Medicine. (2012). Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Vol. 1: Introduction and CSC Framework. Washington, DC: The National Academies Press. p.36-37). In a crisis situation, clinical practice may need to be adjusted in the face of severe medical resource deficits but done in a manner consistent with ethically valid goals and desired outcomes using a population-based approach. The emphasis in a public health emergency must be on improving and maximizing the population’s health while tending to the needs of patients within the constraints of resource limitations (Institute of Medicine. (2012). Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Vol. 1: Introduction and CSC Framework. Washington, DC: The National Academies Press. p.36-37). Planning and proactive implementation of strategies to carefully steward resources may help health care providers avoid reaching the point at which crisis care must be provided and scarce resources allocated.


 
The report addresses these four Key Questions: