A focus group study of health care priority setting at the individual patient, program and health system levels

Faced with an ageing population and newspaper warnings that escalating costs are leading to a health crisis, debate has intensified in Australia and elsewhere on the allocation of limited health resources. But whose values should inform decision-making in the health area, and should the influence of different groups vary with the level of decision-making? These questions were put to 54 members of the public and health professionals in eight focus groups. Unlike previous studies, participants were not asked if particular groups should be involved in decisions but rather through deliberation and discussion nominated their own potential decision makers. This delivered a clear message that participants saw a legitimate role for a broad range of stakeholders in priority setting decisions. The results suggest that qualitative methods of investigation have the potential to improve the legitimacy and accountability of policy decisions by contributing to a better understanding of the values of the public and health professionals.