A population-based model for priority setting across the care continuum and across modalities

Leonie Segal, Duncan Mortimer

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: The Health-sector Wide (HsW) priority setting model is designed to shift the focus of priority setting away from 'program budgets' - that are typically defined by modality or disease-stage - and towards well-defined target populations with a particular disease/health problem. Methods: The key features of the HsW model are i) a disease/health problem framework, ii) a sequential approach to covering the entire health sector, iii) comprehensiveness of scope in identifying intervention options and iv) the use of objective evidence. The HsW model redefines the unit of analysis over which priorities are set to include all mutually exclusive and complementary interventions for the prevention and treatment of each disease/health problem under consideration. The HsW model is therefore incompatible with the fragmented approach to priority setting across multiple program budgets that currently characterises allocation in many health systems. The HsW model employs standard cost-utility analyses and decision-rules with the aim of maximising QALYs contingent upon the global budget constraint for the set of diseases/health problems under consideration. It is recognised that the objective function may include non-health arguments that would imply a departure from simple QALY maximisation and that political constraints frequently limit degrees of freedom. In addressing these broader considerations, the HsW model can be modified to maximise value-weighted QALYs contingent upon the global budget constraint and any political constraints bearing upon allocation decisions. Results: The HsW model has been applied in several contexts, recently to osteoarthritis, that has demonstrated both its practical application and its capacity to derive clear evidenced-based policy recommendations. Conclusion: Comparisons with other approaches to priority setting, such as Programme Budgeting and Marginal Analysis (PBMA) and modality-based cost-effectiveness comparisons, as typified by Australia's Pharmaceutical Benefits Advisory Committee process for the listing of pharmaceuticals for government funding, demonstrate the value added by the HsW model notably in its greater likelihood of contributing to allocative efficiency.

LanguageEnglish
Article number6
JournalCost Effectiveness and Resource Allocation
Volume4
DOIs
Publication statusPublished - 28 Mar 2006
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy

Cite this

@article{0c728fb4d99747fc82e072b346ed82d9,
title = "A population-based model for priority setting across the care continuum and across modalities",
abstract = "Background: The Health-sector Wide (HsW) priority setting model is designed to shift the focus of priority setting away from 'program budgets' - that are typically defined by modality or disease-stage - and towards well-defined target populations with a particular disease/health problem. Methods: The key features of the HsW model are i) a disease/health problem framework, ii) a sequential approach to covering the entire health sector, iii) comprehensiveness of scope in identifying intervention options and iv) the use of objective evidence. The HsW model redefines the unit of analysis over which priorities are set to include all mutually exclusive and complementary interventions for the prevention and treatment of each disease/health problem under consideration. The HsW model is therefore incompatible with the fragmented approach to priority setting across multiple program budgets that currently characterises allocation in many health systems. The HsW model employs standard cost-utility analyses and decision-rules with the aim of maximising QALYs contingent upon the global budget constraint for the set of diseases/health problems under consideration. It is recognised that the objective function may include non-health arguments that would imply a departure from simple QALY maximisation and that political constraints frequently limit degrees of freedom. In addressing these broader considerations, the HsW model can be modified to maximise value-weighted QALYs contingent upon the global budget constraint and any political constraints bearing upon allocation decisions. Results: The HsW model has been applied in several contexts, recently to osteoarthritis, that has demonstrated both its practical application and its capacity to derive clear evidenced-based policy recommendations. Conclusion: Comparisons with other approaches to priority setting, such as Programme Budgeting and Marginal Analysis (PBMA) and modality-based cost-effectiveness comparisons, as typified by Australia's Pharmaceutical Benefits Advisory Committee process for the listing of pharmaceuticals for government funding, demonstrate the value added by the HsW model notably in its greater likelihood of contributing to allocative efficiency.",
author = "Leonie Segal and Duncan Mortimer",
year = "2006",
month = "3",
day = "28",
doi = "10.1186/1478-7547-4-6",
language = "English",
volume = "4",
journal = "Cost Effectiveness and Resource Allocation",
issn = "1478-7547",
publisher = "BioMed Central",

}

A population-based model for priority setting across the care continuum and across modalities. / Segal, Leonie; Mortimer, Duncan.

In: Cost Effectiveness and Resource Allocation, Vol. 4, 6, 28.03.2006.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A population-based model for priority setting across the care continuum and across modalities

AU - Segal, Leonie

AU - Mortimer, Duncan

PY - 2006/3/28

Y1 - 2006/3/28

N2 - Background: The Health-sector Wide (HsW) priority setting model is designed to shift the focus of priority setting away from 'program budgets' - that are typically defined by modality or disease-stage - and towards well-defined target populations with a particular disease/health problem. Methods: The key features of the HsW model are i) a disease/health problem framework, ii) a sequential approach to covering the entire health sector, iii) comprehensiveness of scope in identifying intervention options and iv) the use of objective evidence. The HsW model redefines the unit of analysis over which priorities are set to include all mutually exclusive and complementary interventions for the prevention and treatment of each disease/health problem under consideration. The HsW model is therefore incompatible with the fragmented approach to priority setting across multiple program budgets that currently characterises allocation in many health systems. The HsW model employs standard cost-utility analyses and decision-rules with the aim of maximising QALYs contingent upon the global budget constraint for the set of diseases/health problems under consideration. It is recognised that the objective function may include non-health arguments that would imply a departure from simple QALY maximisation and that political constraints frequently limit degrees of freedom. In addressing these broader considerations, the HsW model can be modified to maximise value-weighted QALYs contingent upon the global budget constraint and any political constraints bearing upon allocation decisions. Results: The HsW model has been applied in several contexts, recently to osteoarthritis, that has demonstrated both its practical application and its capacity to derive clear evidenced-based policy recommendations. Conclusion: Comparisons with other approaches to priority setting, such as Programme Budgeting and Marginal Analysis (PBMA) and modality-based cost-effectiveness comparisons, as typified by Australia's Pharmaceutical Benefits Advisory Committee process for the listing of pharmaceuticals for government funding, demonstrate the value added by the HsW model notably in its greater likelihood of contributing to allocative efficiency.

AB - Background: The Health-sector Wide (HsW) priority setting model is designed to shift the focus of priority setting away from 'program budgets' - that are typically defined by modality or disease-stage - and towards well-defined target populations with a particular disease/health problem. Methods: The key features of the HsW model are i) a disease/health problem framework, ii) a sequential approach to covering the entire health sector, iii) comprehensiveness of scope in identifying intervention options and iv) the use of objective evidence. The HsW model redefines the unit of analysis over which priorities are set to include all mutually exclusive and complementary interventions for the prevention and treatment of each disease/health problem under consideration. The HsW model is therefore incompatible with the fragmented approach to priority setting across multiple program budgets that currently characterises allocation in many health systems. The HsW model employs standard cost-utility analyses and decision-rules with the aim of maximising QALYs contingent upon the global budget constraint for the set of diseases/health problems under consideration. It is recognised that the objective function may include non-health arguments that would imply a departure from simple QALY maximisation and that political constraints frequently limit degrees of freedom. In addressing these broader considerations, the HsW model can be modified to maximise value-weighted QALYs contingent upon the global budget constraint and any political constraints bearing upon allocation decisions. Results: The HsW model has been applied in several contexts, recently to osteoarthritis, that has demonstrated both its practical application and its capacity to derive clear evidenced-based policy recommendations. Conclusion: Comparisons with other approaches to priority setting, such as Programme Budgeting and Marginal Analysis (PBMA) and modality-based cost-effectiveness comparisons, as typified by Australia's Pharmaceutical Benefits Advisory Committee process for the listing of pharmaceuticals for government funding, demonstrate the value added by the HsW model notably in its greater likelihood of contributing to allocative efficiency.

UR - http://www.scopus.com/inward/record.url?scp=33745474382&partnerID=8YFLogxK

U2 - 10.1186/1478-7547-4-6

DO - 10.1186/1478-7547-4-6

M3 - Article

VL - 4

JO - Cost Effectiveness and Resource Allocation

T2 - Cost Effectiveness and Resource Allocation

JF - Cost Effectiveness and Resource Allocation

SN - 1478-7547

M1 - 6

ER -