Research

Decision maker views on priority setting in the Vancouver Island Health Authority

Francois Dionne¹ , Craig Mitton^2,3,5 , Neale Smith² and Cam Donaldson⁴

¹  Department of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, V6T 1Z3, Canada

²  Health Studies, University of British Columbia Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada

³  Child and Family Research Institute, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada

⁴  Institute of Health and Society, Newcastle University, 21 Claremont Place, Newcastle upon Tyne, NE2 4AA, UK

⁵  Health Studies, Faculty of Health and Social Development, University of British Columbia Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada

author email corresponding author email

Cost Effectiveness and Resource Allocation 2008, 6:13doi:10.1186/1478-7547-6-13

Published:	21 July 2008

Abstract

Background

Decisions regarding the allocation of available resources are a source of growing dissatisfaction for healthcare decision-makers. This dissatisfaction has led to increased interest in research on evidence-based resource allocation processes. An emerging area of interest has been the empirical analysis of the characteristics of existing and desired priority setting processes from the perspective of decision-makers.

Methods

We conducted in-depth, face-to-face interviews with 18 senior managers and medical directors with the Vancouver Island Health Authority, an integrated health care provider in British Columbia responsible for a population of approximately 730,000. Interviews were transcribed and content-analyzed, and major themes and sub-themes were identified and reported.

Results

Respondents identified nine key features of a desirable priority setting process: inclusion of baseline assessment, use of best evidence, clarity, consistency, clear and measurable criteria, dissemination of information, fair representation, alignment with the strategic direction and evaluation of results. Existing priority setting processes were found to be lacking on most of these desired features. In addition, respondents identified and explicated several factors that influence resource allocation, including political considerations and organizational culture and capacity.

Conclusion

This study makes a contribution to a growing body of knowledge which provides the type of contextual evidence that is required if priority setting processes are to be used successfully by health care decision-makers.