Setting Priorities and Allocating Resources in Regional Health Authorities: A Report from Two Pilot Exercises Using Program Budgeting and Marginal Analysis

2002 ◽  
Vol 15 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Craig Mitton ◽  
Cam Donaldson ◽  
Lisa Halma ◽  
Nadine Gall
Keyword(s):  
Priority Setting ◽  
Health Sector ◽  
Decision Makers ◽  
Regional Health ◽  
Marginal Analysis ◽  
Health Authorities ◽  
Program Budgeting ◽  
A Priority ◽  
Regional Health Authorities

A significant mandate of Canadian regional health authorities is to set priorities and allocate resources within a limited funding envelope. Program budgeting and marginal analysis is a priority-setting framework used in the health sector. This article discusses the application of the framework in two regional health authorities in Alberta. The framework was demonstrated to be effective in aiding decision makers to set priorities, and wider application of the framework in these health authorities is planned.

scholarly journals Formal priority setting in health care: the Swedish experience

2016 ◽  
Vol 30 (6) ◽  
pp. 891-907 ◽  
Author(s):  
Peter Garpenby ◽  
Karin Bäckman
Keyword(s):  
Health Care ◽  
Priority Setting ◽  
National Level ◽  
Regional Health ◽  
Bottom Up ◽  
Content Type ◽  
Political Conflicts ◽  
Health Authorities ◽  
Financial Pressure ◽  
Regional Health Authorities

Purpose From the late 1980s and onwards health care in Sweden has come under increasing financial pressure, forcing policy makers to consider restrictions. The purpose of this paper is to review experiences and to establish lessons of formal priority setting in four Swedish regional health authorities during the period 2003-2012. Design/methodology/approach This paper draws on a variety of sources, and evidence is organised according to three broad aspects: design and implementation of models and processes, application of evidence and decision analysis tools and decision making and implementation of decisions. Findings The processes accounted for here have resulted in useful experiences concerning technical arrangements as well as political and public strategies. All four sites used a particular model for priority setting that combined top-down- and bottom-up-driven elements. Although the process was authorised from the top it was clearly bottom-up driven and the template followed a professional rationale. New meeting grounds were introduced between politicians and clinical leaders. Overall a limited group of stakeholders were involved. By defusing political conflicts the likelihood that clinical leaders would regard this undertaking as important increased. Originality/value One tendency today is to unburden regional authorities of the hard decisions by introducing arrangements at national level. This study suggests that regional health authorities, in spite of being politically governed organisations, have the potential to execute a formal priority-setting process. Still, to make priority-setting processes more robust to internal as well as external threat remains a challenge.

Validity of the Model for Assessment of Telemedicine: A Delphi study

2016 ◽  
Vol 24 (2) ◽  
pp. 118-125 ◽  
Author(s):  
Kristian Kidholm ◽  
Lise K Jensen ◽  
Tue Kjølhede ◽  
Emilie Nielsen ◽  
Mette B Horup
Keyword(s):  
Delphi Study ◽  
Decision Makers ◽  
Face Validity ◽  
Regional Health ◽  
Modified Delphi ◽  
Health Authorities ◽  
Final Sample ◽  
The Face ◽  
Regional Health Authorities ◽  
Research Organisations

Introduction In 2009, the Model for Assessment of Telemedicine (MAST) was developed within the MethoTelemed project as a framework for description of the effectiveness of telemedicine applications. The goal was for the assessments to be used as basis for decision-making in healthcare systems. Since then, MAST has been used in many European telemedicine studies and is now the most widely used model for assessment of telemedicine. The aim of this study was to assess the face validity of MAST. Methods A modified Delphi process was carried out and included a workshop with a sample of healthcare decision makers. A total of 56 decision makers and experts in telemedicine were invited and 19 persons participated in the two Delphi rounds. Thirteen hospitals or regional health authorities from 12 European countries and six research organisations were represented in the final sample. The participants were asked to assess the importance of the different domains and topics in MAST on a 0–3 Likert scale. Results All respondents completed the two rounds. Based on the answers, the face validity of all MAST domains was confirmed, since all domains were considered moderately or highly important by more than 80% of the respondents. Discussion Even though the study confirmed the validity of MAST, a number of supplements and improvements regarding study design and data collection were suggested. When considering the results it should be noticed that the sample size was small and larger studies are needed to confirm the results.

Beyond Ideology: The Emerging Roles of New Zealand's Crown Health Enterprises

1997 ◽  
Vol 27 (1) ◽  
pp. 89-108 ◽  
Author(s):  
Pauline Barnett ◽  
Laurence Malcolm
Keyword(s):  
Social Services ◽  
Health Sector ◽  
Health Needs ◽  
Political Climate ◽  
Regional Health ◽  
Chief Executives ◽  
Health Authorities ◽  
Strategic Approach ◽  
Crown Health ◽  
Regional Health Authorities

New Zealand has experienced radical public sector restructuring over the last decade, including the corporatization and subsequent privatization of state trading units and the reform of social services, including health. In 1991 a new government proposed and then implemented more radical health reforms, which included the corporatization of state-owned provider units (23 crown health enterprises) and the creation of an internal market with purchasers (four regional health authorities) separated from providers. Interviews with chief executives of crown health enterprises suggest that provider units are seeking a wider role than envisaged, with an interest in the health needs of their populations and undertaking some purchasing on their behalf. The purchasers see a narrower role for crown health enterprises. Both purchasers and providers report that competition between providers is not particularly helpful (and with only limited opportunities for this to occur), with collaboration being seen as more useful. Providers are critical of purchasers' ability to adopt a strategic approach. Unlike other aspects of New Zealand's restructuring, there appears to be a retreat from some of the more radical facets of the reforms, reflecting both the resistance of the health sector and a newly uncertain political climate.

scholarly journals Recruitment into psychiatry

1996 ◽  
Vol 20 (3) ◽  
pp. 177-177 ◽  
Author(s):  
David Storer
Keyword(s):  
Advisory Committee ◽  
Manpower Planning ◽  
Regional Health ◽  
Senior Registrar ◽  
Adequate Supply ◽  
Health Authorities ◽  
Joint Planning ◽  
Regional Health Authorities

The major problem of manpower planning in psychiatry has until fairly recently been one of securing enough posts in the training grades to place doctors wishing to train in psychiatry and to ensure an adequate supply of applicants for consultant posts. Numerous consultant vacancies and a ‘bottleneck’ between registrar and senior registrar grades was the frustrating combination largely consequent upon the failure of some regional health authorities to fund the posts which Joint Planning Advisory Committee (JPAC) had approved.

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