Lydia Kapiriri1, Donya Razavi2. 1. Department of Health, Aging and Society, McMaster University, 1280 Main St. West, Hamilton, Ontario, L8S 4L8, Canada. Electronic address: kapirir@mcmaster.ca. 2. Centre for Health Policy Analysis, McMaster University, 1280 Main St. West, Hamilton, Ontario, L8S 4L8, Canada.
Abstract
BACKGROUND: There is a growing body of literature on systematic approaches to healthcare priority setting from various countries and different levels of decision making. This paper synthesizes the current literature in order to assess the extent to which program budgeting and marginal analysis (PBMA), burden of disease & cost-effectiveness analysis (BOD/CEA), multi-criteria decision analysis (MCDA), and accountability for reasonableness (A4R), are reported to have been institutionalized and influenced policy making and practice. METHODS: We searched for English language publications on health care priority setting approaches (2000-2017). Our sources of literature included PubMed and Ovid databases (including Embase, Global Health, Medline, PsycINFO, EconLit). FINDINGS: Of the four approaches PBMA and A4R were commonly applied in high income countries while BOD/CEA was exclusively applied in low income countries. PBMA and BOD/CEA were most commonly reported to have influenced policy making. The explanations for limited adoption of an approach were related to its complexity, poor policy maker understanding and resource requirements. CONCLUSIONS: While systematic approaches have the potential to improve healthcare priority setting; most have not been adopted in routine policy making. The identified barriers call for sustained knowledge exchange between researchers and policy-makers and development of practical guidelines to ensure that these frameworks are more accessible, applicable and sustainable in informing policy making.
BACKGROUND: There is a growing body of literature on systematic approaches to healthcare priority setting from various countries and different levels of decision making. This paper synthesizes the current literature in order to assess the extent to which program budgeting and marginal analysis (PBMA), burden of disease & cost-effectiveness analysis (BOD/CEA), multi-criteria decision analysis (MCDA), and accountability for reasonableness (A4R), are reported to have been institutionalized and influenced policy making and practice. METHODS: We searched for English language publications on health care priority setting approaches (2000-2017). Our sources of literature included PubMed and Ovid databases (including Embase, Global Health, Medline, PsycINFO, EconLit). FINDINGS: Of the four approaches PBMA and A4R were commonly applied in high income countries while BOD/CEA was exclusively applied in low income countries. PBMA and BOD/CEA were most commonly reported to have influenced policy making. The explanations for limited adoption of an approach were related to its complexity, poor policy maker understanding and resource requirements. CONCLUSIONS: While systematic approaches have the potential to improve healthcare priority setting; most have not been adopted in routine policy making. The identified barriers call for sustained knowledge exchange between researchers and policy-makers and development of practical guidelines to ensure that these frameworks are more accessible, applicable and sustainable in informing policy making.
Authors: Christopher R Vernazza; Katherine Carr; John Wildman; Joanne Gray; Richard D Holmes; Catherine Exley; Robert A Smith; Cam Donaldson Journal: BMC Health Serv Res Date: 2018-06-22 Impact factor: 2.655
Authors: Emmanuel E Effa; Olabisi Oduwole; Anel Schoonees; Ameer Hohlfeld; Solange Durao; Tamara Kredo; Lawrence Mbuagbaw; Martin Meremikwu; Pierre Ongolo-Zogo; Charles Wiysonge; Taryn Young Journal: BMJ Glob Health Date: 2019-07-26