Physician Involvement in Setting Priorities for Health Regions

Harrison, Alexandra M.; Mitton, Craig

doi:10.1016/s0840-4704(10)60625-4

Cited by 9 publications

(10 citation statements)

References 9 publications

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“…We know that priority setting and resource allocation processes need to be both economically sound (making best use of resources to maximize health benefit) and ethical –fair and transparent [1-3]. Evidence from many countries suggests that decision makers struggle to assemble and use relevant evidence [4-7], and to engage clinical stakeholders [8,9] and the public [10-12] in a meaningful fashion. Institutional and cultural barriers stand in the way [13-15].…”

Section: Introductionmentioning

confidence: 99%

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

Smith

Mitton

Bryan

et al. 2013

BMC Health Serv Res

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BackgroundResource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons.MethodsBetween January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating.ResultsAbout one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as ‘good’ or ‘very good’. This paper explores these findings in greater detail and assesses them in context of the larger literature.ConclusionData from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada’s health system leadership teams.

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Section: Introductionmentioning

confidence: 99%

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

Smith

Mitton

Bryan

et al. 2013

BMC Health Serv Res

Self Cite

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“…Obviously politicians care about how policies are received by their electorate, but among healthcare professionals are such powerful opinion leaders that it is necessary to control their reactions. Thus when disinvestment was on the agenda it became important to avoid blame from professionals, to secure their appraisal skills and facilitate changes in programmes and services (Griffiths et al, 2000;Harrison and Mitton, 2004). Hence the politicians in our study focused mainly on "internal legitimacy" (Nedlund, 2012;Nedlund and Baerøe, 2014), what Williams et al (2012, 113) call "legitimacy within the organizational context".…”

Section: Discussionmentioning

confidence: 99%

“…The importance of having doctors on-board when imposing changes in the health service has been pointed out (c.f. Griffiths et al, 2000;Harrison and Mitton, 2004). What has been said above on the political strategies is not contrary to the view that politicians act to circumvent the risk of blame.…”

Section: Political Backstage Strategiesmentioning

confidence: 98%

Political strategies in difficult times – The “backstage” experience of Swedish politicians on formal priority setting in healthcare

Garpenby

Nedlund

2016

Social Science & Medicine

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This paper contributes to the knowledge on the governing of healthcare in a democratic context in times of austerity. Resource allocation in healthcare is a highly political issue but the political nature of healthcare is not always made clear and the role of politicians is often obscure. The absence of politicians in rationing/disinvestment arrangements is usually explained with blame-shifting arguments; they prefer to delegate "the burden of responsibility" to administrative agencies or professionals. Drawing on a case where Swedish regional politicians involved themselves in setting priorities at a more detailed level than previously, the findings suggest that the subject of "blame avoidance" is more complicated than usually assumed. A qualitative case study was designed, involving semi-structured interviews with 14 regionally elected politicians in one Swedish health authority, conducted in June 2011. The interviews were analysed through a thematic analysis in accordance with the "framework approach" by Ritchie and Lewis. Findings show that an overarching strategy among the politicians was to appear united and to suppress conflict, which served to underpin the vital strategy of bringing the medical profession into the process. A key finding is the importance that politicians, when appearing "backstage", attach to the prevention of blame from the medical profession. This case illustrates that one has to take into account that priority settings requires various types of skills and knowledges - not only technical but also political and social. Another important lesson points toward the need to broaden the political leadership repertoire, as leadership in the case of priority setting is not about politicians being all in or all out. The results suggest that in a priority-setting process it is of importance to have politics on-board at an early stage to secure loyalty to the process, although not necessarily being involved in all details.

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“…A Canadian anesthesia and perioperative care research priority-setting framework could assist decision-makers to balance competing demands particularly as research funders are increasingly held accountable for resource allocation. [9][10][11][12] Most Canadians will experience at least one surgery in their lifetime. 13 In 2015-2016, there were approximately 1.47 million inpatient surgical procedures conducted in Canadian hospitals.…”

Section: Résumémentioning

confidence: 99%

Top ten priorities for anesthesia and perioperative research: a report from the Canadian Anesthesia Research Priority Setting Partnership

McKeen

Banfield

McIsaac

et al. 2020

Can J Anesth/J Can Anesth

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The purpose of the Canadian Anesthesia Research Priority Setting Partnership (CAR PSP) was to identify a top ten list of shared priorities for research in anesthesia and perioperative care in Canada. Methods We used the methods of the James Lind Alliance to involve patients, caregivers, healthcare professionals, and researchers in determining the research priorities in Canada. In a first survey, participants submitted questions that they want research to answer about anesthesia and perioperative care. We summarized those responses into a longlist of questions. We reviewed the literature to see if any of those questions were already answered. In a second survey, participants chose up to ten questions from the This article is accompanied by an editorial. Please see Can J Anesth 2020; 67: this issue.

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Physician Involvement in Setting Priorities for Health Regions

Cited by 9 publications

References 9 publications

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey

Political strategies in difficult times – The “backstage” experience of Swedish politicians on formal priority setting in healthcare

Top ten priorities for anesthesia and perioperative research: a report from the Canadian Anesthesia Research Priority Setting Partnership

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