Priority setting of health interventions: the need for multi-criteria decision analysis
- PDF / 275,887 Bytes
- 9 Pages / 610 x 792 pts Page_size
- 26 Downloads / 143 Views
BioMed Central
Open Access
Methodology
Priority setting of health interventions: the need for multi-criteria decision analysis Rob Baltussen*1,2 and Louis Niessen1,3 Address: 1Institute for Medical Technology Assessment (iMTA), ErasmusMC Rotterdam, Rotterdam, The Netherlands, 2Department of Public Health, University Medical Centre Nijmegen, Nijmegen, The Netherlands and 3Department of Health Policy and Management, ErasmusMC, Rotterdam, The Netherlands Email: Rob Baltussen* - [email protected]; Louis Niessen - [email protected] * Corresponding author
Published: 21 August 2006 Cost Effectiveness and Resource Allocation 2006, 4:14
doi:10.1186/1478-7547-4-14
Received: 01 March 2006 Accepted: 21 August 2006
This article is available from: http://www.resource-allocation.com/content/4/1/14 © 2006 Baltussen and Niessen; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typically bad at solving rationally, unaided. They tend to use heuristic or intuitive approaches to simplify complexity, and in the process, important information is ignored. Next, policy makers may select interventions for only political motives. This indicates the need for rational and transparent approaches to priority setting. Over the past decades, a number of approaches have been developed, including evidence-based medicine, burden of disease analyses, cost-effectiveness analyses, and equity analyses. However, these approaches concentrate on single criteria only, whereas in reality, policy makers need to make choices taking into account multiple criteria simultaneously. Moreover, they do not cover all criteria that are relevant to policy makers. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research. In other scientific disciplines, multi-criteria decision analysis is well developed, has gained widespread acceptance and is routinely used. This paper presents the main principles of multicriteria decision analysis. There are only a very few applications to guide resource allocation decisions in health. We call for a shift away from present priority setting tools in health – that tend to focus on single criteria – towards transparent and systematic approaches that ta
Data Loading...
