title: Implementing priority setting frameworks: Insights from leading researchers.
abstract: In spite of a substantial literature developing frameworks for policymakers to use in resource allocation decisions in healthcare, there remains limited published work reporting on the implementation or evaluation of such frameworks in practice. This paper presents findings of a targeted survey of 18 leading researchers around the implementation and evaluation of priority-setting exercises. Approximately one third of respondents knew of situations where recommendations of priority-setting exercises had been implemented, one third knew that recommendations had not been implemented and the final third responded that they did not know whether recommendations had been adopted. The lack of evidence linking the implementation of priority-setting recommendations to equity and efficiency outcomes was highlighted by all respondents. Features identified as facilitating successful implementation of priority-setting recommendations included having a climate ready to accept priority-setting, good leadership or a 'champion' for the priority-setting process and having a health economist to guide the process. Successful disinvestment was very uncommon in the experience of the researchers surveyed. Recommendations emerging from Program Budgeting and Marginal Analysis exercises appeared to be more widely implemented than those coming from alternative processes. Identifying if the process was repeated following the initial process was suggested as a means to measure success.
authors.affiliation: NSW Agency for Clinical Innovation, Level 4, Sage Building, 67 Albert Avenue, Chatswood, NSW 2057, Australia; The George Institute for Global Health, Sydney Medical School, King George V Building 83 Missenden Road Camperdown 2050, Australia. Electronic address: bangell@georgeinstitute.org.au.
authors.forename: Blake
authors.initials: B
authors.lastname: Angell
authors.affiliation: NSW Agency for Clinical Innovation, Level 4, Sage Building, 67 Albert Avenue, Chatswood, NSW 2057, Australia.
authors.forename: Jennie
authors.initials: J
authors.lastname: Pares
authors.affiliation: Sydney School of Public Health, Edward Ford Building (A27), Fisher Road, University of Sydney, NSW 2006, Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Mooney
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration; D006284:Health Plan Implementation; D006292:Health Priorities / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D007857:Leadership; D011640:Public Policy; D012108:Research Personnel
keywords: Implementation; Priority-setting; Public-policy