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Institutional considerations in priority setting: transactions cost perspective on PBMA

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  • Stephen Jan

Abstract

Programme budgeting and marginal analysis (PBMA) is increasingly being used as a method of priority setting in the health care sector. Despite this, PBMA has, on occasions, been subject to problems in its application which can be seen as being ‘institutional’ in nature. This paper examines the extent to which the institutional setting of PBMA affects the way in which it can be conducted. In particular, a transactions costs perspective is taken to analyse the extent to which variation in such costs can alter the incentives of the individual participants. A number of recommendations for improving the sustainability of such projects is then provided. Following this, the implications which this ‘institutional’ approach has for the evaluation of PBMA are set out. Copyright © 2000 John Wiley & Sons, Ltd.

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  • Stephen Jan, 2000. "Institutional considerations in priority setting: transactions cost perspective on PBMA," Health Economics, John Wiley & Sons, Ltd., vol. 9(7), pages 631-641, October.
    • Handle: RePEc:wly:hlthec:v:9:y:2000:i:7:p:631-641
    DOI: 10.1002/1099-1050(200010)9:7<631::AID-HEC531>3.0.CO;2-N
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    Cited by:

    1. Jan, Stephen, 2003. "A perspective on the analysis of credible commitment and myopia in health sector decision making," Health Policy, Elsevier, vol. 63(3), pages 269-278, March.
    2. Smith, Neale & Mitton, Craig & Hall, William & Bryan, Stirling & Donaldson, Cam & Peacock, Stuart & Gibson, Jennifer L. & Urquhart, Bonnie, 2016. "High performance in healthcare priority setting and resource allocation: A literature- and case study-based framework in the Canadian context," Social Science & Medicine, Elsevier, vol. 162(C), pages 185-192.
    3. Patten, San & Mitton, Craig & Donaldson, Cam, 2006. "Using participatory action research to build a priority setting process in a Canadian Regional Health Authority," Social Science & Medicine, Elsevier, vol. 63(5), pages 1121-1134, September.
    4. Mooney, Gavin, 2005. "Communitarian claims and community capabilities: furthering priority setting?," Social Science & Medicine, Elsevier, vol. 60(2), pages 247-255, January.
    5. Peacock, Stuart J. & Richardson, Jeff R.J. & Carter, Rob & Edwards, Diana, 2007. "Priority setting in health care using multi-attribute utility theory and programme budgeting and marginal analysis (PBMA)," Social Science & Medicine, Elsevier, vol. 64(4), pages 897-910, February.
    6. Cornelissen, Evelyn & Mitton, Craig & Davidson, Alan & Reid, R. Colin & Hole, Rachelle & Visockas, Anne-Marie & Smith, Neale, 2014. "Changing priority setting practice: The role of implementation in practice change," Health Policy, Elsevier, vol. 117(2), pages 266-274.
    7. Edward C. F. Wilson & Stuart J. Peacock & Danny Ruta, 2009. "Priority setting in practice: what is the best way to compare costs and benefits?," Health Economics, John Wiley & Sons, Ltd., vol. 18(4), pages 467-478, April.

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