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

Peacock, Stuart J., Mitton, Craig, Ruta, Danny, Donaldson, Cam, Bate, Angela and Hedden, Lindsay (2010) Priority setting in healthcare: towards guidelines for the program budgeting and marginal analysis framework. Expert Review of Pharmacoeconomics & Outcomes Research, 10 (5). pp. 539-552. ISSN 1473-7167

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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.

Item Type: Article
Uncontrolled Keywords: health economics, marginal analysis, priority setting, program budgeting
Subjects: B900 Others in Subjects allied to Medicine
N200 Management studies
Department: Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User: Paul Burns
Date Deposited: 01 Mar 2018 16:30
Last Modified: 11 Oct 2019 21:47

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