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Qualitative methodologies in health-care priority setting research


  • Neale Smith

    (Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC, Canada)

  • Craig Mitton

    (Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC, Canada)

  • Stuart Peacock

    (Centre for Health Economics in Cancer, British Columbia Cancer Agency, Vancouver, BC, Canada)


Priority setting research in health economics has traditionally employed quantitative methodologies and been informed by post-positivist philosophical assumptions about the world and the nature of knowledge. These approaches have been rewarded with well-developed and validated tools. However, it is now commonly noted that there has been limited uptake of economic analysis into actual priority setting and resource allocation decisions made by health-care systems. There seem to be substantial organizational and political barriers. The authors argue in this paper that understanding and addressing these barriers will depend upon the application of qualitative research methodologies. Some efforts in this direction have been attempted; however these are theoretically under-developed and seldom rooted in any of the established qualitative research traditions. Two such approaches - narrative inquiry and discourse analysis - are highlighted here. These are illustrated with examples drawn from a real-world priority setting study. The examples demonstrate how such conceptually powerful qualitative traditions produce distinctive findings that offer unique insight into organizational contexts and decision-maker behavior. We argue that such investigations offer untapped benefits for the study of organizational priority setting and thus should be pursued more frequently by the health economics research community. Copyright © 2008 John Wiley & Sons, Ltd.

Suggested Citation

  • Neale Smith & Craig Mitton & Stuart Peacock, 2009. "Qualitative methodologies in health-care priority setting research," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1163-1175.
  • Handle: RePEc:wly:hlthec:v:18:y:2009:i:10:p:1163-1175
    DOI: 10.1002/hec.1419

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    References listed on IDEAS

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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. 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.
    3. Fischer, Katharina Elisabeth, 2012. "A systematic review of coverage decision-making on health technologies—Evidence from the real world," Health Policy, Elsevier, vol. 107(2), pages 218-230.

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