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Programme budgeting and marginal analysis: a case study of maternity services
J Ratcliffe1, C Donaldson, S Macphee
1Health Economics Research Unit, University of Aberdeen, Foresterhill.
Journal of Public Health Medicine
|June 1, 1996
Summary
Programme budgeting and marginal analysis (PBMA) can guide maternity service purchasing. While modest policy-aligned changes are feasible, significant resource shifts for larger changes face implementation challenges.
Area of Science:
- Health economics
- Healthcare management
- Public health policy
Background:
- Study applied Programme Budgeting and Marginal Analysis (PBMA) framework.
- Focused on developing a purchasing strategy for maternity services.
- Context: Grampian region, Scotland.
Purpose of the Study:
- To apply PBMA to strategic purchasing of maternity services.
- To assess resource distribution and recommend changes.
- To evaluate feasibility of policy-aligned service alterations.
Main Methods:
- Assessed current resource distribution in maternity care.
- Utilized activity data and national policy documents.
- Conducted marginal analysis of proposed changes (cost-benefit).
Main Results:
- Modest maternity service changes aligned with government policy are achievable.
- Cost estimates for larger policy-aligned changes are feasible theoretically.
- Significant resource shifts for substantial changes may be impractical.
Conclusions:
- PBMA is a useful theoretical concept for healthcare purchasing.
- The study illustrates practical challenges in implementing PBMA.
- Implementation requires overcoming resource shift limitations.