3
Table 1. Framework of Resource Stratification
Note: Use of maximal-level resources typically depends on the existence and
functionality of all lower level resources.
Setting Resource Availability
Basic Core resources or fundamental services that are absolutely
necessary for any cancer health care system to function. Basic-level
services typically are applied in a single clinical interaction.
Limited Second-tier resources or services that are intended to produce
major improvements in outcome such as increased survival and
cost-effectiveness and are attainable with limited financial means
and modest infrastructure. Limited-level services may involve single
or multiple interactions. Universal public health interventions
feasible for greater percentage of population than primary target
group.
Enhanced ird-tier resources or services that are optional but important.
Enhanced-level resources should produce further improvements
in outcome and increase the number and quality of options and
patient choice.
Maximal May use high-resource settings' guidelines. High-level/state-of-the
art resources or services that may be used/available in some high-
resource regions and/or may be recommended by high-resource
setting guidelines that do not adapt to resource constraints but
that nonetheless should be considered a lower priority than those
resources or services listed in the other categories on the basis of
extreme cost and/or impracticality for broad use in a resource-
limited environment. To be useful, maximal-level resources
typically depend on the existence and functionality of all lower
level resources. Health budgets still require hard choices, and
private insurers or public systems may carefully ration access to the
most costly therapies.
