Restricted accessResearch articleFirst published online 2002-4
Setting Priorities and Allocating Resources in Regional Health Authorities: A Report from Two Pilot Exercises Using Program Budgeting and Marginal Analysis
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.
Get full access to this article
View all access options for this article.
References
1.
AuldPDonaldsonCMittonCShackleyP. Economic evaluation. In: DetelsRHollandWMcEwanJOmennG, editors. Oxford textbook of public health. 4th ed.Oxford: Oxford University Press; 2000.
2.
DonaldsonCFarrarS. Needs assessment: Developing an economic approach. Health Policy1993; 25: 95–108.
3.
MaddenLHusseyRMooneyGChurchE. Public health and economics in tandem: Programme budgeting, marginal analysis and priority setting in practice. Health Policy1995; 33: 161–168.
4.
MittonCDonaldsonC. Setting priorities in Canadian regional health authorities: A survey of key decision makers. Forthcoming 2001.
5.
MittonCDonaldsonC. Twenty-five years of program budgeting and marginal analysis in the health sector, 1974–99. Journal of Health Services Research and Policy. In press 2001.
6.
MittonCDonaldsonCDeanSWestB. Program budgeting and marginal analysis: A priority setting framework for Canadian regional health authorities. Healthcare Management FORUM2000; 13(4): 24–31.
7.
EylesJBirchS. A population needs-based approach to healthcare resource allocation and planning in Ontario: A link between policy goals and practice?Canadian Journal of Public Health1993; 84(2): 112–7.
8.
SingerPAMartinDKGiacominiMPrudyL. Priority setting for new technologies in medicine: Qualitative case study. British Medical Journal2000; 321: 1316–1318.
9.
HaasMVineyRKristensenEPainCFouldsK. Using program budgeting and marginal analysis to assist population-based strategic planning for coronary heart disease. Health Policy2001; 55: 173–186.
10.
PeacockS. An evaluation of program budgeting and marginal analysis applied in South Australian hospitals. Melbourne: Centre for Health Program Evaluation, Monash University; 1998.
11.
DonaldsonC. Economics, public health and healthcare purchasing: Reinventing the wheel?Health Policy1995; 33: 79–90.
12.
DonaldsonCMooneyG. Needs assessment, priority setting, and contracts for healthcare: An economic view. British Medical Journal1991; 303: 1529–1530.
13.
MooneyGRussellEWeirR. Choices for healthcare: A practical introduction to the economics of health provision. London: Macmillan; 1986.
14.
GerardKMooneyG. QALY league tables: Handle with care. Health Economics1993: 259–64.
15.
StevensARafteryJ, editors. Healthcare needs assessment: The epidemiologically based needs assessment reviews. Second series. Oxford: Radcliffe Medical Press; 1997.
16.
Taber is approximately 60 kilometres east of Lethbridge, and has a population of about 15,000.
17.
MooneyGHaasMVineyRCooperL. 1997. Linking health outcomes to priority setting, planning and resource allocation. New South Wales (Australia): Centre for Health Economics Research and Evaluation; 1997.
18.
In addition to staffing, other potential clinic costs included space, materials and training. As the clinic could use existing space in the hospital or community clinic, associated costs would be negligible; material and training would amount to less then $5,000.
19.
ShiellAHallJ. Advancing health in NSW: Planning in an economic framework. Sydney (Australia): CHERE; 1993.
20.
KellyKPomattoJRipleyCBealsSJoganicE. Importance of early recognition and treatment of deformational plagiocephaly with orthotic cranioplasty. Pediatric Neurosurgery1999; 30: 127–130.
21.
WagnerEAustinBVon KorffM. Improving outcomes in chronic illness. Managed Care Quarterly1996; 4(2): 12–25.
