Priority-setting and rationing in healthcare: Evidence from the English experience
In a context of ever increasing demand, the recent economic downturn has placed further pressure on decision-makers to effectively target healthcare resources. Over recent years there has been a push to develop more explicit evidence-based priority-setting processes, which aim to be transparent and inclusive in their approach and a number of analytical tools and sources of evidence have been developed and utilised at national and local levels. This paper reports findings from a qualitative research study which investigated local priority-setting activity across five English Primary Care Trusts, between March and November 2012. Findings demonstrate the dual aims of local decision-making processes: to improve the overall effectiveness of priority-setting (i.e. reaching ‘correct’ resource allocation decisions); and to increase the acceptability of priority-setting processes for those involved in both decision-making and implementation. Respondents considered priority-setting processes to be compartmentalised and peripheral to resource planning and allocation. Further progress was required with regard to disinvestment and service redesign with respondents noting difficulty in implementing decisions. While local priority-setters had begun to develop more explicit processes, public awareness and input remained limited. The leadership behaviours required to navigate the political complexities of working within and across organisations with differing incentives systems and cultures remained similarly underdeveloped.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 75 (2012)
Issue (Month): 12 ()
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- 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.
- Kapiriri, Lydia & Norheim, Ole F. & Martin, Douglas K., 2009. "Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making?," Social Science & Medicine, Elsevier, vol. 68(4), pages 766-773, February.
- Helen Dickinson & Tim Freeman & Suzanne Robinson & Iestyn Williams, 2011. "Resource scarcity and priority-setting: from management to leadership in the rationing of health care?," Public Money & Management, Taylor & Francis Journals, vol. 31(5), pages 363-370, September.
- Daniels, Norman & Sabin, James E., 2008. "Setting Limits Fairly: Learning to share resources for health," OUP Catalogue, Oxford University Press, edition 2, number 9780195325959.
- Abelson, Julia & Forest, Pierre-Gerlier & Eyles, John & Smith, Patricia & Martin, Elisabeth & Gauvin, Francois-Pierre, 2003. "Deliberations about deliberative methods: issues in the design and evaluation of public participation processes," Social Science & Medicine, Elsevier, vol. 57(2), pages 239-251, July.
- Niessen, Louis W. & Grijseels, Els W. M. & Rutten, Frans F. H., 2000. "The evidence-based approach in health policy and health care delivery," Social Science & Medicine, Elsevier, vol. 51(6), pages 859-869, September.
- Reeleder, David & Goel, Vivek & Singer, Peter A. & Martin, Douglas K., 2006. "Leadership and priority setting: The perspective of hospital CEOs," Health Policy, Elsevier, vol. 79(1), pages 24-34, November.
- Suzanne Robinson & Helen Dickinson & Tim Freeman & Iestyn Williams, 2011. "Disinvestment in health— the challenges facing general practitioner (GP) commissioners," Public Money & Management, Taylor & Francis Journals, vol. 31(2), pages 145-148, March.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:75:y:2012:i:12:p:2386-2393. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.