Priority setting in healthcare: towards guidelines for the program budgeting and marginal analysis framework.

Abstract:

:Economists' approaches to priority setting focus on the principles of opportunity cost, marginal analysis and choice under scarcity. These approaches are based on the premise that it is possible to design a rational priority setting system that will produce legitimate changes in resource allocation. However, beyond issuing guidance at the national level, economic approaches to priority setting have had only a moderate impact in practice. In particular, local health service organizations - such as health authorities, health maintenance organizations, hospitals and healthcare trusts - have had difficulty implementing evidence from economic appraisals. Yet, in the context of making decisions between competing claims on scarce health service resources, economic tools and thinking have much to offer. The purpose of this article is to describe and discuss ten evidence-based guidelines for the successful design and implementation of a program budgeting and marginal analysis (PBMA) priority setting exercise. PBMA is a framework that explicitly recognizes the need to balance pragmatic and ethical considerations with economic rationality when making resource allocation decisions. While the ten guidelines are drawn from the PBMA framework, they may be generalized across a range of economic approaches to priority setting.

authors

Peacock SJ,Mitton C,Ruta D,Donaldson C,Bate A,Hedden L

doi

10.1586/erp.10.66

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

539-52

issue

5

eissn

1473-7167

issn

1744-8379

journal_volume

10

pub_type

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