Resource allocation in social care and the consequences for equitable access: findings from a secondary analysis of a systematic review

Growing demand for social care and resource constraints compel decision-makers to decide how to allocate public resources to social care. Such decisions may result in differences in access to social care between groups in society. In this study we conducted a secondary analysis of articles included in a systematic review on the underpinnings of resource allocation decisions in social care, extending that work to examine the potential consequences of such decisions. We conducted the review in accordance with the PRISMA framework. Through a thematic framework analysis of 37 of the 42 articles included in the parent review, we identified five groups in society that may be disproportionately affected by the consequences of resource allocation decisions on social care: (1) individuals with long-term social care needs (2) informal caregivers, (3) lower socio-economic groups, (4) individuals with limited health literacy skills, and (5) individuals living across different regions. Our findings highlight that allocation decisions in social care particularly affect women and individuals facing language barriers and may create local variation in provision of social care. These findings suggest potential for inequitable access to social care in society and underscore the need for decision-makers to consider the consequences of their allocation decisions.