STAR--people-powered prioritization: a 21st-century solution to allocation headaches

Area of Science:

• Health economics
• Health services research
• Resource allocation

Background:

• Cost-effectiveness analysis (CEA) is crucial for resource allocation in healthcare.
• Barriers in accessibility and acceptability limit CEA's use by local health planners.
• Existing methods do not fully support local budget allocation for diverse health services.

Purpose of the Study:

• To introduce Socio-Technical Allocation of Resources (STAR) as a practical tool for local health planners.
• To demonstrate how STAR can overcome barriers hindering the use of CEA.
• To show STAR's applicability in allocating fixed healthcare budgets.

Main Methods:

• STAR builds upon Cost-Effectiveness Analysis (CEA) and Program Budgeting and Marginal Analysis (PBMA).
• It employs requisite models to assess intervention cost-effectiveness, applying health economics theory.
• An interactive social process engages stakeholders to generate data, develop models, and interpret results.

Main Results:

• STAR was successfully implemented by the Isle of Wight Primary Care Trust for budget allocation in 2008-2009.
• The method facilitated stakeholder engagement in estimating intervention scale, costs, and benefits.
• Visual models of relative cost-effectiveness were developed and interpreted by stakeholders.

Conclusions:

• STAR provides a feasible and effective framework for local health resource allocation.
• The integration of economic principles with stakeholder deliberation enhances decision-making.
• STAR offers a practical solution to improve the utilization of CEA in local health planning.