Otim Michael E, Asante Augustine D, Kelaher Margaret, Anderson Ian P, Jan Stephen
School of Allied Health, Australian Catholic University, North Sydney, NSW, Australia.
School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
Int J Health Plann Manage. 2016 Jul;31(3):277-95. doi: 10.1002/hpm.2287. Epub 2015 Mar 11.
This study aimed to examine the acceptability of programme budgeting and marginal analysis (PBMA) as a tool for priority setting in the Indigenous health sector.
The study uses a mix of quantitative and qualitative methods. A survey of key decision makers in Indigenous health in Victoria was conducted to assess the acceptability of PBMA as a potential tool for priority setting. Respondents comprised 24 bureaucrats from the Victorian Department of Human Services (DHS) and 26 senior executives from the aboriginal community controlled health sector (ACCHS) in Victoria. The survey instrument included both closed-ended and open-ended questions and was administered face-to-face by a trained researcher in 2007-2008. Closed-ended questions were analysed using descriptive statistics, and content analysis was used for the open-ended ones.
The PBMA was well received as having the potential to improve priority setting processes in Indigenous health. Sixty-nine percent of the DHS respondents felt that PBMA was acceptable as a routine decision-making tool, and nearly 80% of ACCHS respondents thought that PBMA was intuitively appealing and would most probably be an acceptable priority setting approach in their organisations. The challenges of using PBMA were related to resource constraints and data intensity.
Programme budgeting and marginal analysis is potentially acceptable within the ACCHS and was perceived as useful in terms of assisting the decision maker to maximise health outcomes, but data systems need to be re-oriented to address its significant data needs.
Proper guidelines need to be developed to facilitate PBMA application within the Indigenous-controlled community health sector. Copyright © 2015 John Wiley & Sons, Ltd.
本研究旨在检验项目预算与边际分析（PBMA）作为原住民卫生部门确定优先事项工具的可接受性。
本研究采用定量和定性相结合的方法。对维多利亚州原住民卫生领域的关键决策者进行了一项调查，以评估PBMA作为确定优先事项潜在工具的可接受性。受访者包括来自维多利亚州人类服务部（DHS）的24名官员和来自维多利亚州原住民社区控制卫生部门（ACCHS）的26名高级管理人员。调查问卷包括封闭式和开放式问题，由一名经过培训的研究人员于2007年至2008年进行面对面调查。使用描述性统计分析封闭式问题，对开放式问题采用内容分析法。
PBMA作为一种有可能改善原住民卫生领域优先事项确定流程的方法受到了好评。69%的DHS受访者认为PBMA可作为一种常规决策工具接受，近80%的ACCHS受访者认为PBMA直观上有吸引力，很可能是其所在组织可接受的确定优先事项方法。使用PBMA的挑战与资源限制和数据密集度有关。
项目预算与边际分析在ACCHS内可能是可接受的，并且在协助决策者使健康结果最大化方面被认为是有用的，但数据系统需要重新调整以满足其大量的数据需求。
需要制定适当的指导方针，以促进PBMA在原住民控制的社区卫生部门中的应用。版权所有© 2015约翰·威利父子有限公司。
