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Priority-setting in New Zealand: translating principles into practice.

T Ashton¹, J Cumming, N Devlin

¹Department of Community Health, University of Auckland, Auckland.

Journal of Health Services Research & Policy

|February 24, 2001

Summary

New Zealand

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Area of Science:

Health economics
Health services research
Public health policy

Background:

New Zealand Health Funding Authority proposed a principles-based approach for healthcare purchasing priorities in 1998.
The approach incorporates economic methods like programme budgeting and marginal analysis, and cost-utility analysis.
Key principles include effectiveness, cost, equity of health outcomes, Māori health, and acceptability.

Purpose of the Study:

To describe and critique the practical challenges of implementing the proposed prioritization principles.
To evaluate the proposed methods for assessing service effectiveness and cost.
To assess the contribution of the proposed framework to systematic and transparent healthcare decision-making.

Main Methods:

Critique of a discussion paper proposing a principles-based approach to healthcare prioritization.
Analysis of economic methods including programme budgeting, marginal analysis, and cost-utility analysis.
Examination of principles such as effectiveness, cost, equity, Māori health, and acceptability.

Main Results:

The proposed approach offers a systematic, explicit, and transparent method for prioritizing health services.
Shifting to 'thinking at the margin' and value-for-money assessments can improve decision-making quality.
The approach is more suitable for certain services than others, and informed judgment remains crucial.

Conclusions:

The proposed prioritization framework represents a significant advancement in healthcare resource allocation.
Further methodological considerations are needed, including health gain measurement and combining qualitative/quantitative data.
Ensuring consistency across decision-making levels is essential for effective implementation.

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