Prioritization MICA: a Web-based application to prioritize public health resources

Although setting priorities is an important step in making public health policy, the benefit of using epidemiology to prioritize scarce public health resources has not been fully recognized. This situation is mostly due to the complexity of proposed models for setting priorities. We describe a public health priority setting model, Missouri Information for Community Assessment Priority Setting Model (Priority MICA), which uses epidemiologic measures available in most surveillance systems across the United States. Priority MICA uses data from birth and death certificates, hospital discharges, emergency departments, risk factors from the Behavioral Risk Factors Surveillance System, and eight epidemiologic measures to construct six priority criteria: size (the number of emergency department visits, hospitalizations, and deaths), severity (number of deaths of people younger than 65), urgency (trends in deaths and hospital morbidity), preventability (evidence-based score), community support (score of social support for preventive action), and racial-disparity (race comparison through death and morbidity rate ratio). Priority MICA is part of a Web-based interactive tool that makes available data from a wide variety of surveillance systems (http://www.dhss.mo.gov/MICA). The top 10 priority diseases determined by Priority MICA were compared to a more traditional method of ranking diseases by mortality rates. Using the additional criteria in Priority MICA identified four more priority diseases than were identified using just mortality while the ranking of the other six priority diseases differed between methods.