Articles and Research

The following reports, articles and books provide essential background and information regarding our company and priority setting within the health care context. Keep checking back as this list will be updated as new resources become available.

‘Real-world’ health care priority setting using explicit decision criteria: a systematic review of the literature

Ian Cromwell, Stuart J Peacock and Craig Mitton, BMC Health Services Research, 2015.

Health care decision making requires making resource allocation decisions among programs, services,
and technologies that all compete for a finite resource pool. Methods of priority setting that use explicitly defined criteria can aid health care decision makers in arriving at funding decisions in a transparent and systematic way. The purpose of this paper is to review the published literature and examine the use of criteria-based methods in ‘real-world’ health care allocation decisions.

LHIN Priority Setting & Decision Making Framework Toolkit

Tool Kit Report Cover

Craig Mitton and Jennifer Gibson were commissioned by LHIN Collaborative (LHINC) to develop a priority setting and decision making framework that could be applied throughout the LHIN network while ensuring flexibility and adaptability to address local concerns.

Health care priority setting: principles, practice and challenges

Mitton C, Donaldson C. Cost Effectiveness and Resource Allocation 2004, 2:3.

This paper presents a detailed step by step guide for carrying out a priority setting process based on the PBMA framework. This guide is based on the authors’ experience in using this approach primarily in the UK and Canada, but as well draws on a growing literature of PBMA studies in various countries.

Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority

Mitton C, Dionne F, Damji R, Campbell D, Bryan S. BMC Health Services Research 2011;11:169.

The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division.

Rational Disinvestment

Donaldson C, Bate A, Mitton C, Dionne F, Ruta D. QJM 2010; 103(10):801-807.

With potential budget claw backs of 20% to be found in UK health care in forthcoming years, the question arises as to how these might be achieved. Based on the long-standing economic principle of marginal analysis, a framework for managing such a National Health Service credit crunch is outlined.

Programme Budgeting and Marginal Analysis (PBMA): A common resource management framework for doctors and managers?

Ruta D, Mitton C, Bate A, Donaldson C. British Medical Journal 2005;330:1501-1503.

Recent NHS reforms give doctors increased responsibility for efficient and fair use of resources. Programme budgeting and marginal analysis is one way to ensure the views of all stakeholders are properly represented.

Using economics for pragmatic and ethical priority setting: two checklists for doctors and managers.

Peacock S, Ruta D, Mitton C, Donaldson C, Bate A, Murtagh M. British Medical Journal 2006;332:482-485.

Doctors and managers have to make tough decisions about what services to provide from their budgets. Economic approaches can help, but they also need to take into account the practical and ethical challenges faced by healthcare professionals.

Priority Setting Toolkit: Guide to the Use of Economics in Healthcare Decision Making

Cam Donaldson and Craig Mitton – BMJ Books, 2004.

This work provides a guide to how economics can be used to manage scarcity of resources in health services. It outlines the principles of economics in a non-technical manner, before going on to address the issues of how to apply the principles in day to day health services management.

Credit Crunch Health Care: How economics can save our publicly-funded health services

Cam Donaldson – Policy Press, 2011

The credit crunch is a threat to publicly-funded health care. World-leading health economist Cam Donaldson defends our systems on the same basis as public service detractors; economic efficiency. However, protecting government funding of health care is not enough. Donaldson goes on to show how we can get more out of our systems by addressing issues of value for money.