Participation in health care priority-setting through the eyes of the participants

2002 ◽  
Vol 7 (4) ◽  
pp. 222-229 ◽  
Author(s):  
Douglas Martin ◽  
Julia Abelson ◽  
Peter Singer
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Priority Setting ◽  
Decision Makers ◽  
Medical Specialist ◽  
Committee Chair ◽  
The Public ◽  
Health Care Priority Setting ◽  
Patient Representative

Objectives: The literature on participation in priority-setting has three key gaps: it focuses on techniques for obtaining public input into priority-setting that are consultative mechanisms and do not involve the public directly in decision-making; it focuses primarily on the public's role in priority-setting, not on all potential participants; and the range of roles that various participants play in a group making priority decisions has not been described. To begin addressing these gaps, we interviewed individuals who participated on two priority-setting committees to identify key insights from participants about participation. Methods: A qualitative study consisting of interviews with decision-makers, including patients and members of the public. Results: Members of the public can contribute directly to important aspects of priority-setting. The participants described six specific priority-setting roles: committee chair, administrator, medical specialist, medical generalist, public representative and patient representative. They also described the contributions of each role to priority-setting. Conclusions: Using the insights from decision-makers, we have described lessons related to direct involvement of members of the public and patients in priority-setting, and have identified six roles and the contributions of each role.

Evaluation of a deliberative approach to citizen involvement in health care priority setting

2014 ◽  
Vol 27 (1) ◽  
pp. 5-19 ◽  
Author(s):  
Iestyn Williams ◽  
Daisy Phillips ◽  
Charles Nicholson ◽  
Heather Shearer
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Decision Making ◽  
Public Engagement ◽  
Priority Setting ◽  
Primary Care Trust ◽  
Content Type ◽  
The Public ◽  
Novel Approach ◽  
Health Care Priority Setting

Purpose – The purpose of this paper is to describe and evaluate a novel approach to citizen engagement in health priority setting carried out in the context of Primary Care Trust (PCT) commissioning in the English National Health Service. Design/methodology/approach – Four deliberative events were held with 139 citizens taking part in total. Events design incorporated elements of the Twenty-first Century Town Meeting and the World Café, and involved specially-designed dice games. Evaluation surveys reporting quantitative and qualitative participant responses were combined with follow-up interviews with both PCT staff and members of the public. An evaluation framework based on previous literature was employed. Findings – The evaluation demonstrates high levels of enjoyment, learning and deliberative engagement. However, concerns were expressed over the leading nature of the voting questions and, in a small minority of responses, the simplified scenarios used in dice games. The engagement exercises also appeared to have minimal impact on subsequent Primary Care Trust resource allocation, confirming a wider concern about the influence of public participation on policy decision making. The public engagement activities had considerable educative and political benefits and overall the evaluation indicates that the specific deliberative tools developed for the exercise facilitated a high level of discussion. Originality/value – This paper helps to fill the gap in empirical evaluations of deliberative approaches to citizen involvement in health care priority setting. It reports on a novel approach and considers a range of implications for future research and practice. The study raises important questions over the role of public engagement in driving priority setting decision making.

scholarly journals Health Priority Setting in Iran: Evaluating Against the Social Values Framework

2016 ◽  
Vol 8 (10) ◽  
pp. 212
Author(s):  
Hakimeh Mostafavi ◽  
Arash Rashidian ◽  
Mohammad Arab ◽  
Mohammad R. V. Mahdavi ◽  
Kioomars Ashtarian
Keyword(s):  
Health Care ◽  
Health System ◽  
Priority Setting ◽  
Social Values ◽  
City Council ◽  
Decision Makers ◽  
The Public ◽  
Health Technologies ◽  
Health Priority ◽  
The Social

<p><strong>Background:</strong> Health systems, as part of the social system, consider public values. This study was conducted to examine the role of social values in the health priority setting in the Iranian health system.</p><p><strong>Methods:</strong> In this qualitative case study, three main data sources were used: literature, national documents, and key informants who were purposefully selected from health care organizations and other related institutions. Data was analyzed and interpreted using the Clark-Weale Framework.</p><p><strong>Results:</strong> According to our results, the public indirectly participates in decision-making. The public representatives participate in the meetings of the health priority setting as parliament members, representatives of some unions, members of the city council, and donors. The transparency of the decisions and the accountability of the decision makers are low. Decision makers only respond to complaints of the Audit Court and the Inspection Organization. Individual choice, although respected in hospitals and clinics, is limited in health care networks because of the referral system. Clinical effectiveness is considered in insurance companies and some hospitals. There are no technical abilities to determine the cost-effectiveness of health technologies; however, some international experiences are employed. Equity and solidarity are considered in different levels of the health system.</p><p><strong>Conclusion:</strong> Social values are considered in the health priority decisions in limited ways. It seems that the lack of an appropriate value-based framework for priority setting and also the lack of public participation are the major defects of the health system. It is recommended that health policymakers invite different groups of people and stakeholders for active involvement in health priority decisions. </p>

Receptive rationing: reflections and suggestions for priority setters in health care

2015 ◽  
Vol 29 (6) ◽  
pp. 701-710 ◽  
Author(s):  
Iestyn Williams
Keyword(s):  
Health Care ◽  
Priority Setting ◽  
Design Methodology ◽  
Decision Makers ◽  
Evidence Based ◽  
Priority Setting Process ◽  
Content Type ◽  
Setting Process ◽  
External Stakeholders ◽  
Health Care Priority Setting

Purpose – The purpose of this paper is to take forward consideration of context in health care priority setting and to offer some practical strategies for priority setters to increase receptiveness to their work. Design/methodology/approach – A number of tools and methods have been devised with the aim of making health care priority setting more robust and evidence based. However, in order to routinely take and implement priority setting decisions, decision makers require the support, or at least the acquiescence, of key external parties. In other words, the priority setting process requires a receptive context if it is to proceed unhindered. Findings – The priority setting process requires a receptive context if it is to proceed unhindered. Originality/value – This paper develops the concept of legitimacy in the “authorising environment” in priority setting and describes strategies which might help decision makers to create a receptive context, and to manage relationships with external stakeholders.

Value congruence in health care priority setting: social values, institutions and decisions in three countries

2014 ◽  
Vol 10 (2) ◽  
pp. 113-132 ◽  
Author(s):  
Claudia Landwehr ◽  
Dorothea Klinnert
Keyword(s):  
Public Health ◽  
Health Care ◽  
Priority Setting ◽  
Institutional Design ◽  
Social Values ◽  
Public Acceptance ◽  
Value Judgments ◽  
The Public ◽  
The United Kingdom ◽  
Health Care Priority Setting

AbstractMost developed democracies have faced the challenge of priority setting in health care by setting up specialized agencies to take decisions on which medical services to include in public health baskets. Under the influence of Daniels and Sabin’s seminal work on the topic, agencies increasingly aim to fulfil criteria of procedural justice, such as accountability and transparency. We assume, however, that the institutional design of agencies also and necessarily reflects substantial value judgments on the respective weight of distributive principles such as efficiency, need and equality. The public acceptance of prioritization decisions, and eventually of the health care system at large, will ultimately depend not only on considerations of procedural fairness, but also on the congruence between a society’s values and its institutions. We study social values, institutions and decisions in three countries (France, Germany and the United Kingdom) in order to assess such congruence and formulate expectations on its effects.

scholarly journals What should guide priority setting in health care? A study of public preferences in Sweden

2019 ◽  
Author(s):  
Linda Ryen ◽  
Niklas Jakobsson ◽  
Mikael Svensson
Keyword(s):  
Health Care ◽  
Disease Severity ◽  
Priority Setting ◽  
Treatment Cost ◽  
Multinomial Logistic Regression ◽  
Public Preferences ◽  
The Public ◽  
Trade Offs ◽  
Sample Proportion ◽  
Health Care Priority Setting

Priority setting criteria in health care are commonly set by politicians on behalf of the public. It is desirable that these criteria are in line with societal preferences in order to gain acceptance for decisions on what health services to provide and reimburse. We study public preferences for the allocation of the health care budget based on age, disease severity and treatment cost. We use data from a web survey where 1,160 respondents provided their views on priority setting criteria in health care. The data was analyzed using multinomial logistic regression analyses and one-sample proportion tests. Between 13 to 25 percent of the respondents agree that age, disease severity and treatment cost are valid criteria for priority setting, whereas 56 to 80 percent support weaker versions of the statements. We also find significant differences within the population; young men are for example more prone to support explicit priority setting criteria. Our results imply a need for trade-offs in health care priority setting if balancing differing preferences among population groups. To achieve a greater understanding for priority setting in general, and for using economic reasoning in particular, there may be a need for more public transparency to make clear that priority setting is inevitable. Published: Online December 2019

In Search of Informed Input: A Systematic Approach to Involving the Public in Community Decision Making

1996 ◽  
Vol 9 (4) ◽  
pp. 48-52 ◽  
Author(s):  
Julia Abelson ◽  
Jonathan Lomas
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Public Participation ◽  
Health Care System ◽  
Public Involvement ◽  
Systematic Approach ◽  
Decision Makers ◽  
Scarce Resources ◽  
The Public ◽  
Community Decision

Given the task of distributing scarce resources, decision makers are faced with the question of how to involve an increasingly threatened and disenfranchised public in decisions affecting their communities. This article introduces a systematic approach to public involvement in community decision-making and identifies key elements in the design of institutionally driven public participation exercises. Examples are drawn from the health care system restructuring experiences of three Ontario communities.

scholarly journals Evidence use as sociomaterial practice? A qualitative study of decision-making on introducing service innovations in health care

2021 ◽  
pp. 1-25
Author(s):  
Simon Turner ◽  
Danielle D´Lima ◽  
Jessica Sheringham ◽  
Nick Swart ◽  
Emma Hudson ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Evidence Use

Public participation in health care priority setting: A scoping review

Health Policy ◽  
2009 ◽  
Vol 91 (3) ◽  
pp. 219-228 ◽  
Author(s):  
Craig Mitton ◽  
Neale Smith ◽  
Stuart Peacock ◽  
Brian Evoy ◽  
Julia Abelson
Keyword(s):  
Health Care ◽  
Public Participation ◽  
Scoping Review ◽  
Priority Setting ◽  
Health Care Priority Setting

Framing Information Technology Governance in the Public Sector: Opportunities and Challenges

2015 ◽  
Vol 11 (4) ◽  
pp. 89-101 ◽  
Author(s):  
Khalifa Al-Farsi ◽  
Ramzi EL Haddadeh
Keyword(s):  
Decision Making ◽  
Information Technology ◽  
Public Sector ◽  
It Governance ◽  
Decision Makers ◽  
The Public ◽  
Technology Governance ◽  
Support Organizations ◽  
Information Technology Governance ◽  
Decision Making Processes

Information technology governance is considered one of the innovative practices that can provide support for decision-makers. Interestingly, it has become increasingly a de facto for organizations in seeking to optimise their performance. In principle, information technology governance has emerged to support organizations in the integration of information technology (IT) infrastructures and the delivery of high-quality services. On the other hand, decision-making processes in public sector organisations can be multi-faceted and complex, and decision makers play an important role in implementing technology in the public sector. The aim of this paper is to shed some light on current opportunities and challenges that IT governance is experiencing in the context of public sector services. In this respect, this paper examines the factors influencing the decision-making process to fully appreciate IT governance. Furthermore, this study focuses on combining institutional and individual perspectives to explain how individuals can take decisions in response to institutional influences.

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