Health Studies, University of British Columbia Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada.
Cost Eff Resour Alloc. 2008 Jul 21;6:13. doi: 10.1186/1478-7547-6-13.
Decisions regarding the allocation of available resources are a source of growing dissatisfaction for healthcare decision-makers. This dissatisfaction has led to increased interest in research on evidence-based resource allocation processes. An emerging area of interest has been the empirical analysis of the characteristics of existing and desired priority setting processes from the perspective of decision-makers.
We conducted in-depth, face-to-face interviews with 18 senior managers and medical directors with the Vancouver Island Health Authority, an integrated health care provider in British Columbia responsible for a population of approximately 730,000. Interviews were transcribed and content-analyzed, and major themes and sub-themes were identified and reported.
Respondents identified nine key features of a desirable priority setting process: inclusion of baseline assessment, use of best evidence, clarity, consistency, clear and measurable criteria, dissemination of information, fair representation, alignment with the strategic direction and evaluation of results. Existing priority setting processes were found to be lacking on most of these desired features. In addition, respondents identified and explicated several factors that influence resource allocation, including political considerations and organizational culture and capacity.
This study makes a contribution to a growing body of knowledge which provides the type of contextual evidence that is required if priority setting processes are to be used successfully by health care decision-makers.
对于医疗保健决策者来说，如何分配现有资源的决策是导致其日益不满的根源。这一不满情绪促使人们对基于证据的资源分配流程的研究产生了浓厚的兴趣。决策者从自身角度出发，对现有和期望的优先排序流程特征进行实证分析，这一新兴领域逐渐受到关注。
我们对不列颠哥伦比亚省温哥华岛卫生局的 18 名高级管理人员和医疗主任进行了深入的面对面访谈。温哥华岛卫生局是一家综合性医疗服务提供商，负责管理约 73 万人口。我们对访谈内容进行了转录和内容分析，并确定和报告了主要主题和次要主题。
受访者确定了理想的优先排序流程的九个关键特征：包括基线评估、使用最佳证据、明确性、一致性、明确且可衡量的标准、信息传播、公平代表性、与战略方向保持一致以及对结果进行评估。现有的优先排序流程在大多数期望特征上都存在不足。此外，受访者还确定并阐述了影响资源分配的几个因素，包括政治考虑因素、组织文化和能力。
本研究为日益增多的知识体系做出了贡献，为医疗保健决策者成功使用优先排序流程提供了所需的背景证据。
