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Involving the general public in priority setting: experiences from Australia


  • Wiseman, V.
  • Mooney, G.
  • Berry, G.
  • Tang, K. C.


The discussion over whether community preferences have a legitimate role to play in priority setting has been highly polarised. Skeptics warn of the risk of establishing a 'dictatorship of the uninformed', while advocates proclaim the legitimacy of the participatory process. The one group who appears not to be consulted in this debate is the citizens themselves. In this study, a convenience sample of 373 citizens attending two medical clinics in central Sydney were surveyed about whether the general public has a legitimate role to play in informing priority setting in health care. Respondents were presented with three different levels of priority setting: across health care programmes, across medical procedures, and at a global level. To assist respondents in understanding the choices and trade-offs involved, they were given information about current levels of funding and the cost-effectiveness of each alternative. Respondents were asked whether they felt the preferences of the general public should be used to inform priority setting at each level. Of particular interest was the question of whether their willingness to use public preferences depended on the level of priority setting. Respondents were also asked about who else's preferences should be used to inform priority setting at each level. The results suggest that the public overwhelmingly want their preferences to inform priority-setting decisions in health care. This was seen to be particularly important in informing decisions about how to prioritise across broad health care programmes and about the criteria to be used to allocate funds across different population groups. In contrast, the preferences of medical professionals and health service managers were rated most highly in relation to the prioritisation of different treatments and medical procedures. In most cases, however, respondents did not advocate the use of one particular group's preferences. Even when the preferences of the general public were considered most important, it was felt that any decision-making process needed to be informed by the preferences of a range of groups. The preferences of politicians were viewed as least important to processes of priority setting in health care.

Suggested Citation

  • Wiseman, V. & Mooney, G. & Berry, G. & Tang, K. C., 2003. "Involving the general public in priority setting: experiences from Australia," Social Science & Medicine, Elsevier, vol. 56(5), pages 1001-1012, March.
  • Handle: RePEc:eee:socmed:v:56:y:2003:i:5:p:1001-1012

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    Cited by:

    1. van Exel, Job & Baker, Rachel & Mason, Helen & Donaldson, Cam & Brouwer, Werner, 2015. "Public views on principles for health care priority setting: Findings of a European cross-country study using Q methodology," Social Science & Medicine, Elsevier, vol. 126(C), pages 128-137.
    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. Li, Kathy K. & Abelson, Julia & Giacomini, Mita & Contandriopoulos, Damien, 2015. "Conceptualizing the use of public involvement in health policy decision-making," Social Science & Medicine, Elsevier, vol. 138(C), pages 14-21.
    4. repec:eee:hepoli:v:122:y:2018:i:2:p:147-156 is not listed on IDEAS
    5. Benning, Tim M. & Dellaert, Benedict G.C., 2013. "Paying more for faster care? Individuals' attitude toward price-based priority access in health care," Social Science & Medicine, Elsevier, vol. 84(C), pages 119-128.
    6. Xesfingi, Sofia & Vozikis, Athanassios, 2014. "Citizens’ Preferences on Health Care Expenditure Allocation: Evidence from Greece," MPRA Paper 63419, University Library of Munich, Germany.
    7. Abelson, Julia & Forest, Pierre-Gerlier & Eyles, John & Casebeer, Ann & Martin, Elisabeth & Mackean, Gail, 2007. "Examining the role of context in the implementation of a deliberative public participation experiment: Results from a Canadian comparative study," Social Science & Medicine, Elsevier, vol. 64(10), pages 2115-2128, May.
    8. Broqvist, Mari & Garpenby, Peter, 2015. "It takes a giraffe to see the big picture – Citizens' view on decision makers in health care rationing," Social Science & Medicine, Elsevier, vol. 128(C), pages 301-308.
    9. Abelson, Julia & Giacomini, Mita & Lehoux, Pascale & Gauvin, Francois-Pierre, 2007. "Bringing `the public' into health technology assessment and coverage policy decisions: From principles to practice," Health Policy, Elsevier, vol. 82(1), pages 37-50, June.
    10. Nuti, Sabina & Vainieri, Milena & Bonini, Anna, 2010. "Disinvestment for re-allocation: A process to identify priorities in healthcare," Health Policy, Elsevier, vol. 95(2-3), pages 137-143, May.
    11. Thurston, Wilfreda E. & MacKean, Gail & Vollman, Ardene & Casebeer, Ann & Weber, Myron & Maloff, Bretta & Bader, Judy, 2005. "Public participation in regional health policy: a theoretical framework," Health Policy, Elsevier, vol. 73(3), pages 237-252, September.
    12. Rosenberg-Yunger, Zahava R.S. & Thorsteinsdóttir, Halla & Daar, Abdallah S. & Martin, Douglas K., 2012. "Stakeholder involvement in expensive drug recommendation decisions: An international perspective," Health Policy, Elsevier, vol. 105(2), pages 226-235.


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