Priority Setting in Action: Purchasing Dilemmas

✍ Scribed by Frank Honigsbaum; John Richards; Chris Ham

Publisher: Chapman and Hall/CRC
Year: 2018
Tongue: English
Leaves: 209
Category: Library

No coin nor oath required. For personal study only.

✦ Synopsis

The power of purchasers exposes the weaknesses of conventional thinking on the costs and benefits of priorities. Health policy analysts now have to develop rational criteria to support decisions in a process which may be inherently intuitive. This authoritative and practical text points the way towards clear choices in resource allocation and the implications of these choices on expenditure diverted among different health care programmes.

✦ Table of Contents

Content: Intro
Title Page
Copyright Page
Contents
List of contributors
Participants
Foreword
Preface
1 The international context
Oregon
The Netherlands, New Zealand and Sweden
United Kingdom
Issues arising
2 The Southampton experience
Simulation seminar of 1991
The growth of commissioning
Rational planning and decision making --
1994
Trial run
Development of the health strategy
Stakeholder consultation
Identifying criteria
Views of experts
Determining importance of criteria
Preliminary ranking of 49 options
Ranking of the options
Purchasing plan
Rankings compared Comparison with GP rankingsApproach to disinvestment
Overview of procedure
3 Lessons learned
Relevance of the Southampton experience
No quick fix
Coping with many options
Rational planning
Limited cost-utility data rule out marginal analysis
Needs assessment essential
Clearer definition of criteria
Assigning weights to criteria
Health gain versus equity
No clear way to relate criteria to choices
Pragmatic criteria strongly influence rankings
Protection for chronic sick and deprived groups
Stakeholder consultation necessary and needs more care
The public's role GPs can help decide prioritiesMore involvement by provider groups
Efficiency before exclusions
Disinvestments cannot always be ignored
4 Emergent themes
Health economics and priority setting: nonsense on stilts?
How not to ration health care: the moral perils of utilitarian decision making
The strengths and limitations of programme budgeting
Reflections on a brief return to strategic planning
The view from a small plane over Hampshire
Promoting equity and avoiding prejudice
The future strategic role of commissions
When the elephants fight, it is the grass which suffers Reflections of the non-executive members5 Outstanding issues
National direction or local discretion?
How to involve stakeholders
How to involve providers
How to make better use of economic evaluation
Protection for the chronic sick and vulnerable groups
How to guard against age and lifestyle discrimination
Appendix A Local health problems
Appendix B Options for change and indicative costs
Appendix C Marginal value
Appendix D Health benefits
Appendix E Other benefits
Appendix F Stakeholder consultation results
Appendix G Expert panel: personal profiles
Index

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