title: Priority setting in the Provincial Health Services Authority: case study for the 2005/06 planning cycle.
abstract: BACKGROUND
  Building on a survey of key decision-makers within the Provincial Health Services Authority (PHSA) of British Columbia, a process for prioritizing new service options within this organization for the 2005/06 budget cycle was developed and implemented by senior managers and researchers at the University of British Columbia.
  
  
  METHODS
  A case study approach was taken in which development and implementation of the prioritization process was documented and feedback was obtained from decision-makers to evaluate the activity. Information from the literature was also used to identify areas for improvement.
  
  
  RESULTS
  The 13-member Executive Committee of the PHSA conducted the prioritization. Criteria were defined and weighted, and options for new funding were explicitly rated against them. Multi-attribute decision software was used to rank options based on an overall benefit score. Cost-benefit ratios were also derived and program options were further ranked according to decision-makers' "gut-feel." Ranking between the methods was comparable, and each method contributed to the final decisions by the Executive Committee regarding which programs would receive limited new funding.
  
  
  CONCLUSIONS
  Through a collaborative effort between decision-makers and researchers, the PHSA was able to shift from allocating new resources on the basis of politics and bargaining to an evidence-driven, transparent, defensible process. Lessons learned from the current activity will help inform future priority setting in the PHSA and should provide insight for decision-makers elsewhere.
authors.affiliation: Centre for Healthcare Innovation and Improvement, B.C. Research Institute for Children's and Women's Health, Vancouver, BC. craig.mitton@ubc.ca
authors.forename: Craig
authors.initials: C
authors.lastname: Mitton
authors.forename: Jennifer
authors.initials: J
authors.lastname: Mackenzie
authors.forename: Lynda
authors.initials: L
authors.lastname: Cranston
authors.forename: Flora
authors.initials: F
authors.lastname: Teng