Resource allocation in NHS dentistry: recognition of societal preferences (RAINDROP): study protocol

Area of Science:

• Health economics
• Public health policy
• Decision science

Background:

• Healthcare systems face resource scarcity, necessitating difficult allocation decisions.
• Programme Budgeting and Marginal Analysis (PBMA) is a tool for resource allocation with mixed evidence on its effectiveness and uptake.
• There is a lack of evidence on integrating public preferences into PBMA processes.

Purpose of the Study:

• To undertake, evaluate, and refine a PBMA process within NHS dentistry in England.
• To systematically gather public preferences using Willingness to Pay (WTP) methodology.
• To investigate and develop the incorporation of WTP into PBMA.

Main Methods:

• Recruitment of stakeholders (commissioners, dentists, public health, patient representatives) for a PBMA panel.
• Refinement of the PBMA process using participatory action research principles.
• Evaluation through interviews, focus groups, and observation; parallel WTP surveys with a representative sample of English adults.

Main Results:

• The study will investigate and develop the PBMA process, specifically the use of WTP.
• Challenges in panel engagement and stakeholder acceptance are anticipated and will be mitigated through relationship building.
• Data analysis will employ the Framework approach for qualitative data, with WTP elicitation designed to minimize biases.

Conclusions:

• The research aims to enhance PBMA by integrating public preferences, offering a more robust approach to healthcare resource allocation.
• Findings will inform the practical application and refinement of PBMA in public health settings.
• The study contributes to understanding how to systematically incorporate public values into resource allocation decisions.