Hospital priority setting with an appeals process: a qualitative case study and evaluation

Madden, Shannon; Martin, Douglas K.; Downey, Sarah; Сингер, Петер

doi:10.1016/j.healthpol.2004.11.002

Cited by 35 publications

(31 citation statements)

References 14 publications

(16 reference statements)

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“…The strategy involves (i) describing priority setting in the context where it occurs; (ii) evaluating the description using an ethical framework; and (iii) improving priority setting based on the evaluation. Since this describe-evaluate-improve strategy is generalizable and has been used to improve priority setting processes in different health care institutions [20][21][22][23][24][25][26][27] the lessons learnt from using this approach can serve as exemplars for similar efforts in developing countries.…”

Section: Capturing Priority Setting Experiencesmentioning

confidence: 99%

A Strategy to Improve Priority Setting in Developing Countries

Kapiriri

Martin

2007

Health Care Anal

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Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. Priority setting in developing countries is fraught with uncertainty due to lack of credible information, weak priority setting institutions, and unclear priority setting processes. Efforts to improve priority setting in these contexts have focused on providing information and tools. In this paper we argue that priority setting is a value laden and political process, and although important, the available information and tools are not sufficient to address the priority setting challenges in developing countries. Additional complementary efforts are required. Hence, a strategy to improve priority setting in developing countries should also include: (i) capturing current priority setting practices, (ii) improving the legitimacy and capacity of institutions that set priorities, and (iii) developing fair priority setting processes.

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Section: Capturing Priority Setting Experiencesmentioning

confidence: 99%

A Strategy to Improve Priority Setting in Developing Countries

Kapiriri

Martin

2007

Health Care Anal

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“…Consequently, people use informal mechanisms to get what they want (e.g. back door lobbying), which introduces un- fairness (12,15). Even within resource-poor contexts, there should be mechanisms where dissensions can be presented and discussed.…”

Section: Discussionmentioning

confidence: 99%

Hospital Priority Setting in a Mixed Public/Private Health System: A Case Study of a Chilean Hospital

2009

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Abstract:The purpose of this study was to describe, using qualitative case study methods, and evaluate, using the ethical framework 'accountability for reasonableness', priority setting in a hospital in Chile. In policy making contexts that have historically been dominated by central authority, especially where there are limited resources, fair priority setting processes can empower people, foster social learning, improve the quality of the decisions, enhance compliance with policy decisions, and increase public confidence in the hospital.Key words: priority setting, centralization, health care, accountability for reasonableness, culture ESTABLECIMIENTO DE PRIORIDADES EN UN SISTEMA DE SALUD MIXTO PÚBLICO/ PRIVADO: ESTUDIO DE CASO EN UN HOSPITAL CHILENOResumen: El propósito de este estudio fue describir, a través del uso de métodos cualitativos en un estudio de caso, y evaluar, siguiendo la estructura ética de "Administración Razonable", el proceso de priorización en salud en un hospital de Chile. En el contexto de las políticas públicas ha dominado históricamente la centralización de la autoridad, especialmente cuando los recursos son limitados. Un proceso justo de priorización en salud puede empoderar a las personas, mejorar y aumentar el proceso de aprendizaje social, mejorar la calidad de las decisiones, aumentar el grado de adherencia y satisfacción de las políticas desarrolladas y aumentar la confianza pública en el hospital.Palabras clave: priorización, centralización, sistema de salud, Administración Razonable, cultura ESTABELECIMENTO DE PRIORIDADES EM UM SISTEMA DE SAÚDE MISTO PÚBLICO/ PRIVADO: ESTUDO DE CASO EM HOSPITAL CHILENOResumo: O propósito deste estudo foi descrever, por métodos qualitativos em um estudo de caso, e avaliar, seguindo a estrutura ética de "administração razoável", o processo de priorização em saúde em um hospital chileno. No contexto das políticas públicas onde tem dominado historicamente a centralização da autoridade, especialmente quando os recursos são limitados, um processo justo de priorização em saúde pode empoderar as pessoas, melhorar e aumentar o processo de aprendizagem social, melhorar a qualidade das decisões, aumentar o grau de aderência e satisfação das políticas desenvolvidas e a confiança pública no hospital.Palavras-chave: priorização, centralização, sistema de saúde, distribuição responsável, cultura.

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“…For instance, there have been a number of investigations of priority setting in Canadian healthcare organizations based on the Accountability for Reasonableness (A4R) framework (Bell et al, 2004;Madden et al, 2005;Martin et al, 2003). Other Canadian research into priority setting and resource allocation also has been selfcharacterized as case studies, reporting results in the form of themes developed inductively Patten et al, 2005).…”

Section: The Current State Of Qualitative Methods In Priority Settingmentioning

confidence: 99%

Qualitative methodologies in health‐care priority setting research

2009

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Priority setting research in health economics has traditionally employed quantitative methodologies and been informed by post-positivist philosophical assumptions about the world and the nature of knowledge. These approaches have been rewarded with well-developed and validated tools. However, it is now commonly noted that there has been limited uptake of economic analysis into actual priority setting and resource allocation decisions made by health-care systems. There seem to be substantial organizational and political barriers. The authors argue in this paper that understanding and addressing these barriers will depend upon the application of qualitative research methodologies. Some efforts in this direction have been attempted; however these are theoretically under-developed and seldom rooted in any of the established qualitative research traditions. Two such approaches - narrative inquiry and discourse analysis - are highlighted here. These are illustrated with examples drawn from a real-world priority setting study. The examples demonstrate how such conceptually powerful qualitative traditions produce distinctive findings that offer unique insight into organizational contexts and decision-maker behavior. We argue that such investigations offer untapped benefits for the study of organizational priority setting and thus should be pursued more frequently by the health economics research community.

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Hospital priority setting with an appeals process: a qualitative case study and evaluation

Cited by 35 publications

References 14 publications

A Strategy to Improve Priority Setting in Developing Countries

A Strategy to Improve Priority Setting in Developing Countries

Hospital Priority Setting in a Mixed Public/Private Health System: A Case Study of a Chilean Hospital

Qualitative methodologies in health‐care priority setting research

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