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      Past, present and future challenges in health care priority setting : Findings from an international expert survey

      research-article
      William Hall , Iestyn Williams , Neale Smith , Marthe Gold , Joanna Coast , Lydia Kapiriri , M. Danis , Craig Mitton
      Journal of Health Organization and Management
      Emerald Publishing
      Strategic management, Hospital management, Resource management, Health and medicine, Health authorities

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          Abstract

          Purpose

          Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a “magic bullet” is replaced by an appreciation for the interplay between evidence, interests, culture, and outcomes, progress in relation to these dimensions requires assessment of achievements to date and identification of areas where knowledge and practice require attention most urgently. The paper aims to discuss these issues.

          Design/methodology/approach

          An international survey was administered to experts in the area of priority setting. The survey consisted of open-ended questions focusing on notable achievements, policy and practice challenges, and areas for future research in the discipline of priority setting. It was administered online between February and March of 2015.

          Findings

          “Decision-making frameworks” and “Engagement” were the two most frequently mentioned notable achievements. “Priority setting in practice” and “Awareness and education” were the two most frequently mentioned policy and practical challenges. “Priority setting in practice” and “Engagement” were the two most frequently mentioned areas in need of future research.

          Research limitations/implications

          Sampling bias toward more developed countries. Future study could use findings to create a more concise version to distribute more broadly.

          Practical implications

          Globally, these findings could be used as a platform for discussion and decision making related to policy, practice, and research in this area.

          Originality/value

          Whilst this study reaffirmed the continued importance of many longstanding themes in the priority setting literature, it is possible to also discern clear shifts in emphasis as the discipline progresses in response to new challenges.

          Related collections

          Most cited references38

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          Diffusion of innovations in service organizations: systematic review and recommendations.

          This article summarizes an extensive literature review addressing the question, How can we spread and sustain innovations in health service delivery and organization? It considers both content (defining and measuring the diffusion of innovation in organizations) and process (reviewing the literature in a systematic and reproducible way). This article discusses (1) a parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, (2) clear knowledge gaps where further research should be focused, and (3) a robust and transferable methodology for systematically reviewing health service policy and management. Both the model and the method should be tested more widely in a range of contexts.
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            • Record: found
            • Abstract: not found
            • Article: not found

            E-mail Survey Response Rates: A Review

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              • Record: found
              • Abstract: found
              • Article: found

              Social values in health priority setting a conceptual framework

              Purpose It is commonly recognized that the setting of health priorities requires value judgements and that these judgements are social. Justifying social value judgements is an important element in any public justification of how priorities are set. The purpose of this paper is to review a number of social values relating both to the process and content of prioritysetting decisions. Designmethodologyapproach A set of key process and content values basic to health priority setting is outlined, and normative analysis applied to those values to identify their key features, possible interpretations in different cultural and institutional contexts, and interactions with other values. Findings Process values are found to be closely linked, such that success in increasing, for example, transparency may depend on increasing participation or accountability, and content values are found often to be hidden in technical criteria. There is a complex interplay between value and technical components of priority setting, and between process and content values. Levels of economic development, culture and need will all play a part in determining how different systems balance the values in their decisions. Originalityvalue Technical analyses of health priority setting are commonplace, but approaching the issues from the perspective of social values is a more recent approach and one which this paper seeks to refine and develop.
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                Author and article information

                Contributors
                Journal
                JHOM
                10.1108/JHOM
                Journal of Health Organization and Management
                JHOM
                Emerald Publishing
                1477-7266
                18 April 2018
                17 May 2018
                : 32
                : 3
                : 444-462
                Affiliations
                [1]Department of Medicine, University of British Columbia , Vancouver, Canada
                [2]Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada
                [3] University of Birmingham , Birmingham, UK
                [4]The City College of New York, New York, New York, USA
                [5] University of Bristol , Bristol, UK
                [6]Department of Medicine, McMaster University , Hamilton, Canada
                [7]Howard Hughes Medical Institute, University of Chicago , Chicago, Illinois, USA
                [8]School of Population and Public Health, University of British Columbia , Vancouver, Canada
                Author notes
                William Hall is the corresponding author and can be contacted at: william.hall@ubc.ca
                Article
                608673 JHOM-01-2018-0005.pdf JHOM-01-2018-0005
                10.1108/JHOM-01-2018-0005
                29771204
                bce3a07b-9998-4787-a7ae-04bed9a90aca
                © Emerald Publishing Limited
                History
                : 01 January 2018
                : 07 January 2018
                : 13 February 2018
                : 25 February 2018
                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 40, Pages: 19, Words: 7929
                Categories
                research-article, Research paper
                cat-HSC, Health & social care
                cat-HMAN, Healthcare management
                Custom metadata
                yes
                yes
                JOURNAL
                included

                Health & Social care
                Health authorities,Health and medicine,Resource management,Hospital management,Strategic management

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