Priority Setting and Resource Allocation in Healthcare: Learning from Local Government
Introduction: Although seemingly disparate in nature, healthcare and local governments share a commitment to serving the public - as citizens and as patients - by ensuring their health and long-term wellbeing. Beyond this mutual interest, both areas face growing scarcity of resources while demands for services continue to rise. As a result, leaders in both disciplines must face difficult decisions related to setting priorities and allocating resources.
Method: From an established position within healthcare including decades of understanding and application of health economics, a team of Canadian Health Economists and Health Services researchers launched an exploratory literature review of priority setting and resource allocation (PSRA) in local government. Searches of six databases and multiple grey literature resources were conducted – 565 papers were identified, 121 papers were left for full review, and 38 were used to inform the research topic.
Results: Budgeting theory and practice in local government were identified as drivers for PSRA. Budgeting theories included: Incrementalism and Rationalism, and budgeting practice included: Line-item, Program, Performance, Outcome, Participatory, and Priority Based Budgeting. Each theory and practice is outlined in the article as well as key comparisons to current practice in healthcare. Ultimately, the intention is to create stronger links between healthcare and local government by highlighting common challenges and approached to this critical area of study and practice.
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