Resource Allocation in a National Dental Service Using Program Budgeting Marginal Analysis

Area of Science:

• Health Economics
• Dental Public Health
• Resource Allocation

Background:

• Healthcare systems face scarce resources requiring strategic allocation.
• Program Budgeting Marginal Analysis (PBMA) is an economic framework for resource allocation.
• Incorporating patient and public values, like willingness to pay (WTP), into PBMA is novel, especially in dentistry.

Purpose of the Study:

• To conduct a PBMA in a national dental setting, integrating public WTP values.
• To explore the practical application of PBMA with WTP in dental resource allocation.
• To inform decision-making for optimizing dental resource distribution.

Main Methods:

• A panel of stakeholders (commissioners, dentists, public health staff, academics) conducted the PBMA.
• Services were evaluated against weighted criteria, informed by a national WTP survey.
• Decisions on service investment and disinvestment were made via anonymous electronic voting.

Main Results:

• Recommended investment in general dentist access, care home dentistry, and dental public health support.
• Recommended disinvestment in orthodontics and routine scaling and polishing.
• The PBMA process successfully highlighted resource allocation challenges.

Conclusions:

• The PBMA process, incorporating WTP, is a viable framework for dental resource allocation.
• Implementation of recommendations requires operationalization by decision-makers.
• This study provides practical insights for future dental PBMA initiatives.