Priority Setting in the Provincial Health Services Authority: Case Study for the 2005/06 Planning Cycle

Abstract

Introduction: Building on a survey of key decision-makers within the Provincial Health Services Authority (PHSA) of British Columbia, a process for prioritizing new service options within this organization for the 2005/06 budget cycle was developed and implemented by senior managers and researchers at the University of British Columbia. Methods: A case study approach was taken in which development and implementation of the prioritization process was documented and feedback was obtained from decision-makers to evaluate the activity. Information from the literature was also used to identify areas for improvement. Results: The 13-member Executive Committee of the PHSA conducted the prioritization. Criteria were defined and weighted, and options for new funding were explicitly rated against them. Multi-attribute decision software was used to rank options based on an overall benefit score. Cost-benefit ratios were also derived and program options were further ranked according to decision-makers' "gut-feel." Ranking between the methods was comparable, and each method contributed to the final decisions by the Executive Committee regarding which programs would receive limited new funding. Conclusion: Through a collaborative effort between decision-makers and researchers, the PHSA was able to shift from allocating new resources on the basis of politics and bargaining to an evidence-driven, transparent, defensible process. Lessons learned from the current activity will help inform future priority setting in the PHSA and should provide insight for decision-makers elsewhere.

Análise de Decisão Multicritérios (MCDA): uma revisão rápida sobre os critérios utilizados na Avaliação de Tecnologias em Saúde

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Qualitative methodologies in health‐care priority setting research

“…Key issues and problems such as organizational change and change management, the nature of leadership, and the balance between research evidence and other forms of information are all areas in which qualitative insights would be of considerable interest. Since applied health economics research often investigates the introduction into organizations of new systematic ways of setting priorities (for instance, Carter et al, 2000;Mitton et al, , 2006Peacock et al, 1997), qualitative research is an appropriate way to assess the experience and perceptions of health-care managers and health professionals in such situations.…”

Priority Setting Meets Multiple Streams: A Match to Be Further Examined? Comment on "Introducing New Priority Setting and Resource Allocation Processes in a Canadian Healthcare Organization: A Case Study Analysis Informed by Multiple Streams Theory

“…Fifth, key to the success in changing the priority setting approach to PBMA was the extensive work that has been done by the research team and others in Canada in promoting, trialling, researching, and writing up, various PBMA exercises. [15][16][17][18][19][20] This shows how important it is to have available evidence to hand when the problem and politics stream converge to demand a policy response. Building such an evidence base takes considerable time and resource.…”