Priority setting in healthcare: towards guidelines for the program budgeting and marginal analysis framework

Area of Science:

• Health Economics
• Public Health Policy
• Decision Science

Background:

• Economists utilize principles like opportunity cost and marginal analysis for rational priority setting.
• Economic approaches have limited practical impact at local health service organization levels.
• Challenges exist in implementing economic appraisal evidence in resource allocation decisions.

Purpose of the Study:

• To describe and discuss ten evidence-based guidelines for designing and implementing Program Budgeting and Marginal Analysis (PBMA).
• To facilitate successful priority setting exercises within healthcare organizations.
• To bridge the gap between economic theory and practical resource allocation.

Main Methods:

• The study draws upon the Program Budgeting and Marginal Analysis (PBMA) framework.
• Guidelines are evidence-based and focus on practical implementation.
• The approach emphasizes balancing economic rationality with pragmatic and ethical considerations.

Main Results:

• Ten specific guidelines for successful PBMA implementation are presented.
• The guidelines aim to enhance the effectiveness of resource allocation decisions.
• PBMA provides a structured approach to address competing claims on scarce health resources.

Conclusions:

• The ten guidelines offer a practical framework for economic approaches to priority setting.
• PBMA facilitates the integration of economic rationality, ethical, and pragmatic factors.
• These guidelines can be generalized to various economic priority setting methods in healthcare.