Quantitative Model for Measuring Line-Drawing Inequity
The law draws lines. It draws lines between manslaughter and murder, negligence and gross negligence, speeding and driving legally, and capital gains and ordinary income. Those lines invariably cause undesirable results. In particular, lines in the law cause inequity because they impose different treatment on similarly-situated persons. Despite line-drawing’s inequity, analysts generally shun inequity and embrace the quantitative comforts of inefficiency analysis. This Article introduces a quantitative model for measuring inequity, so the preference for quantitative measures no longer justifies the disdain for inequity analysis. Instead, democratic and philosophical ideals should make now-quantifiable inequity analyses the analytical tool of choice.The quantitative model introduces a robust method for measuring line-drawing inequity. The quantitative information it provides illustrates that the location of a line affects the amount of inequity line-drawing causes. The model provides an opportunity to test and rethink the relationship between equity and efficiency. It demonstrates that the governed may reduce line-drawing inequity by altering their behavior to avoid negative line-drawing effects. The model also provides quantitative evidence that the perceived tension between equity and efficiency analyses is misinformed. In fact, the model shows that efficiency and equity may correlate in the line-drawing context. Finally, the Article illustrates that the criteria used to draw a line may result in the inappropriate orientation of the line. The Article concludes that excessive inequity may signal a need to change the orientation of a line or otherwise alter the law to reduce line-drawing inequity.
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Community refinement of glaucoma referrals
AbstractAim To describe a Manchester-based glaucoma referral refinement scheme designed to reduce the number of false-positive referrals to the hospital eye service. To report on the first years results of this scheme and its financial costs to the NHS.Methods Patients with suspected glaucoma, instead of being referred to their GP and then on to the hospital eye service, were referred to a group of specially trained community optometrists working to an agreed set of referral criteria. Those patients who did not meet the referral criteria were returned to the referring optometrist, while those who met the referral criteria were referred directly to Manchester Royal Eye Hospital. The patient's GP was informed in all cases.Results The number of suspect glaucoma cases referred to the Manchester Royal Eye Hospital was reduced by 40%. This figure is close to the percentage of false-positive referrals measured at Manchester Royal Eye Hospital prior to the onset of this study. The information accompanying referral has been improved and the scheme produces a small financial cost saving to the NHS of approximately £17 per patient.Conclusion Community refinement of suspect glaucoma offers some important benefits over the current referral pathway.