Debate over healthcare often focuses on two key issues: quality and cost. However, because of the unique characteristics of healthcare, this relationship is not as simple as it might seem. A recent Supreme Court of Canada judgement directly addressing aspects of quality of care, combined with...

ABSTRACT A major driver of cost growth in health care is the rapid increase in the utilisation of existing technology and not simply the adoption of new technology. Health economists and their health technology assessment colleagues have become obsessed by technology adoption questions and have...

Ten years ago, Holm's highly influential paper "Goodbye to the simple solutions: the second phase of priority setting" was published [Holm S. Goodbye to the simple solutions: the second phase of priority setting in health care. British Medical Journal 1998;317:1000-7]. Whilst attending the 2nd...

Due to resource scarcity, every health system worldwide must decide what services to fund, and conversely, what services not to fund. In order to institute and refine a macro-level priority setting framework within a large, urban health authority in Alberta, Canada, researchers and decision...

Background: Decision makers within the Calgary Health Region adopted and applied programme budgeting and marginal analysis (PBMA) for priority-setting activity across major service portfolios within the Region. Methods: Seventeen in-depth qualitative interviews were conducted with senior...

As resources in health care are scarce, health authorities and other health organizations are charged with determining how best to spend limited resources. While a number of formal approaches to priority setting within health authorities have been used internationally, there has been limited...

Spurred by a desire to improve quality of care and to understand the relative value of medical treatments, there has been a recent surge of interest in publicly funded comparative effectiveness research (CER) in the US. As health technology assessment (HTA) shares some of the same goals as CER,...

Programme budgeting and marginal analysis (PBMA) is a priority setting approach that assists decision makers in choosing among resource demands. This paper describes and evaluates the process of implementing PBMA in a Canadian regional health authority, and draws out key lessons learned from...

Spurred by a desire to improve quality of care and to understand the relative value of medical treatments, there has been a recent surge of interest in publicly funded comparative effectiveness research (CER) in the US. As health technology assessment (HTA) shares some of the same goals as CER,...