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Overcoming barriers to priority setting using interdisciplinary methods


  • Peacock, Stuart
  • Mitton, Craig
  • Bate, Angela
  • McCoy, Bonnie
  • Donaldson, Cam


Ten years ago, Holm's highly influential paper "Goodbye to the simple solutions: the second phase of priority setting" was published [Holm S. Goodbye to the simple solutions: the second phase of priority setting in health care. British Medical Journal 1998;317:1000-7]. Whilst attending the 2nd International Conference on Priorities in Health Care in London, Holm argued that the search for a rational set of decision-making rules was no longer adequate. Instead, the priority setting process itself was now thought to be more complex. Ten years later, the Conference returns to the UK for the first time, and it is timely to describe some new tools intended to assist both researchers and decision-makers seeking to develop both rational and fair and legitimate priority setting processes. In this paper we argue that to do so, researchers and decision-makers need to adopt an interdisciplinary and collaborative approach to priority setting. We focus on program budgeting and marginal analysis (PBMA) and bring together three hitherto separate interdisciplinary strands of the PBMA literature. Our aim is to assist researchers and decision-makers seeking to effectively develop and implement PBMA in practice. Specifically, we focus on the use of multi-criteria decision analysis, participatory action research, and accountability for reasonableness, drawn from the disciplines of decision analysis, sociology, and ethics respectively.

Suggested Citation

  • Peacock, Stuart & Mitton, Craig & Bate, Angela & McCoy, Bonnie & Donaldson, Cam, 2009. "Overcoming barriers to priority setting using interdisciplinary methods," Health Policy, Elsevier, vol. 92(2-3), pages 124-132, October.
  • Handle: RePEc:eee:hepoli:v:92:y:2009:i:2-3:p:124-132

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    References listed on IDEAS

    1. Peacock, Stuart J. & Richardson, Jeff R.J. & Carter, Rob & Edwards, Diana, 2007. "Priority setting in health care using multi-attribute utility theory and programme budgeting and marginal analysis (PBMA)," Social Science & Medicine, Elsevier, vol. 64(4), pages 897-910, February.
    2. Rob Baltussen & Elly Stolk & Dan Chisholm & Moses Aikins, 2006. "Towards a multi-criteria approach for priority setting: an application to Ghana," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 689-696.
    3. Mitton, Craig R. & Donaldson, Cam, 2003. "Setting priorities and allocating resources in health regions: lessons from a project evaluating program budgeting and marginal analysis (PBMA)," Health Policy, Elsevier, vol. 64(3), pages 335-348, June.
    4. Donaldson, Cam & Farrar, Shelley, 1993. "Needs assessment: developing an economic approach," Health Policy, Elsevier, vol. 25(1-2), pages 95-108, September.
    5. Patten, San & Mitton, Craig & Donaldson, Cam, 2006. "Using participatory action research to build a priority setting process in a Canadian Regional Health Authority," Social Science & Medicine, Elsevier, vol. 63(5), pages 1121-1134, September.
    6. Sugden, Robert & Williams, Alan, 1978. "The Principles of Practical Cost-Benefit Analysis," OUP Catalogue, Oxford University Press, number 9780198770411.
    7. Cornwall, Andrea & Jewkes, Rachel, 1995. "What is participatory research?," Social Science & Medicine, Elsevier, vol. 41(12), pages 1667-1676, December.
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    Cited by:

    1. Angell, Blake & Pares, Jennie & Mooney, Gavin, 2016. "Implementing priority setting frameworks: Insights from leading researchers," Health Policy, Elsevier, vol. 120(12), pages 1389-1394.
    2. MacDonald, Jo-Anne & Edwards, Nancy & Davies, Barbara & Marck, Patricia & Guernsey, Judith Read, 2012. "Priority setting and policy advocacy by nursing associations: A scoping review and implications using a socio-ecological whole systems lens," Health Policy, Elsevier, vol. 107(1), pages 31-43.
    3. Baltussen, Rob & Youngkong, Sitapon & Paolucci, Francesco & Niessen, Louis, 2010. "Multi-criteria decision analysis to prioritize health interventions: Capitalizing on first experiences," Health Policy, Elsevier, vol. 96(3), pages 262-264, August.
    4. Hipgrave, David B. & Alderman, Katarzyna Bolsewicz & Anderson, Ian & Soto, Eliana Jimenez, 2014. "Health sector priority setting at meso-level in lower and middle income countries: Lessons learned, available options and suggested steps," Social Science & Medicine, Elsevier, vol. 102(C), pages 190-200.
    5. Axel C. Mühlbacher & Anika Kaczynski, 2016. "Making Good Decisions in Healthcare with Multi-Criteria Decision Analysis: The Use, Current Research and Future Development of MCDA," Applied Health Economics and Health Policy, Springer, vol. 14(1), pages 29-40, February.
    6. Stuart J. Peacock & Craig Mitton, 2012. "Priority Setting Methods in Health Services," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 53 Edward Elgar Publishing.
    7. Robinson, Suzanne & Williams, Iestyn & Dickinson, Helen & Freeman, Tim & Rumbold, Benedict, 2012. "Priority-setting and rationing in healthcare: Evidence from the English experience," Social Science & Medicine, Elsevier, vol. 75(12), pages 2386-2393.


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