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OP97 Program Budgeting Marginal Analysis For The Real World

Philippa Anderson, Pippa Anderson

International Journal of Technology Assessment in Health Care, Volume: 33, Issue: S1, Pages: 44 - 45

Swansea University Author: Pippa Anderson

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Abstract

Program budgeting marginal analysis (PBMA) accommodates economic analysis, multi-stakeholder inputs, values, needs and perspectives within one framework in order to determine optimal use of available resources to deliver the highest ‘health value’. Two pilot PBMA projects in two different services w...

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Published in: International Journal of Technology Assessment in Health Care
ISSN: 0266-4623 1471-6348
Published: 2018
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URI: https://cronfa.swan.ac.uk/Record/cronfa38314
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first_indexed 2018-01-26T05:16:33Z
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spelling 2018-08-15T12:42:51.7606629 v2 38314 2018-01-25 OP97 Program Budgeting Marginal Analysis For The Real World 128cdedfba6e5e6374fdc85d5c78c428 Pippa Anderson Pippa Anderson true false 2018-01-25 FGMHL Program budgeting marginal analysis (PBMA) accommodates economic analysis, multi-stakeholder inputs, values, needs and perspectives within one framework in order to determine optimal use of available resources to deliver the highest ‘health value’. Two pilot PBMA projects in two different services were conceived and completed in a Welsh Health Board (HB) as ‘proof of concept’ methodology for robust prioritization decisons and for improving quality of patient care, outcomes and experience. The pilots were essential to enable development of a ‘bespoke’ PBMA process for the HB to implement. The PBMA methods were based on methods and criteria for successful PBMAs reported in the literature. Project teams and stakeholder communities supported the PBMAs which were executed over a 12 -18 month period between 2013–15. Group decision support methods were used to facilitate meetings and decision making. Formal interviews with project team members and informal feedback informed development of the final PBMA framework. Identifying the costs and resources attributable to services and those that could be moved around services was challenging. Evidence of outcomes and ‘health value’ was more easily available. One PBMA pilot recommended that some modest service reorganization and quality improvement could be made within budget but no substantial improvement/decommissioning could be undertaken. The other pilot agreed a disinvestment decision on the basis of evidence and reallocated the resources to a higher value service. The HB commissioning team found the information from the PBMA ‘journey’ as useful as the recommendations. A PBMA framework for the HB was devised. A ‘Prudent PBMA’ framework trimmed back to the critical essentials enables success criteria to be met. PBMA is to be adopted as a ‘way of working’ to operationalize resource reallocation and disinvestment in the ‘real world’ of Welsh healthcare commissioning. Journal Article International Journal of Technology Assessment in Health Care 33 S1 44 45 0266-4623 1471-6348 PBMA, resource allocation, prioritisation 12 1 2018 2018-01-12 10.1017/S0266462317001696 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2018-08-15T12:42:51.7606629 2018-01-25T20:22:37.3994726 College of Human and Health Sciences Swansea Centre for Health Economics Philippa Anderson 1 Pippa Anderson 2
title OP97 Program Budgeting Marginal Analysis For The Real World
spellingShingle OP97 Program Budgeting Marginal Analysis For The Real World
Pippa Anderson
title_short OP97 Program Budgeting Marginal Analysis For The Real World
title_full OP97 Program Budgeting Marginal Analysis For The Real World
title_fullStr OP97 Program Budgeting Marginal Analysis For The Real World
title_full_unstemmed OP97 Program Budgeting Marginal Analysis For The Real World
title_sort OP97 Program Budgeting Marginal Analysis For The Real World
author_id_str_mv 128cdedfba6e5e6374fdc85d5c78c428
author_id_fullname_str_mv 128cdedfba6e5e6374fdc85d5c78c428_***_Pippa Anderson
author Pippa Anderson
author2 Philippa Anderson
Pippa Anderson
format Journal article
container_title International Journal of Technology Assessment in Health Care
container_volume 33
container_issue S1
container_start_page 44
publishDate 2018
institution Swansea University
issn 0266-4623
1471-6348
doi_str_mv 10.1017/S0266462317001696
college_str College of Human and Health Sciences
hierarchytype
hierarchy_top_id collegeofhumanandhealthsciences
hierarchy_top_title College of Human and Health Sciences
hierarchy_parent_id collegeofhumanandhealthsciences
hierarchy_parent_title College of Human and Health Sciences
department_str Swansea Centre for Health Economics{{{_:::_}}}College of Human and Health Sciences{{{_:::_}}}Swansea Centre for Health Economics
document_store_str 0
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description Program budgeting marginal analysis (PBMA) accommodates economic analysis, multi-stakeholder inputs, values, needs and perspectives within one framework in order to determine optimal use of available resources to deliver the highest ‘health value’. Two pilot PBMA projects in two different services were conceived and completed in a Welsh Health Board (HB) as ‘proof of concept’ methodology for robust prioritization decisons and for improving quality of patient care, outcomes and experience. The pilots were essential to enable development of a ‘bespoke’ PBMA process for the HB to implement. The PBMA methods were based on methods and criteria for successful PBMAs reported in the literature. Project teams and stakeholder communities supported the PBMAs which were executed over a 12 -18 month period between 2013–15. Group decision support methods were used to facilitate meetings and decision making. Formal interviews with project team members and informal feedback informed development of the final PBMA framework. Identifying the costs and resources attributable to services and those that could be moved around services was challenging. Evidence of outcomes and ‘health value’ was more easily available. One PBMA pilot recommended that some modest service reorganization and quality improvement could be made within budget but no substantial improvement/decommissioning could be undertaken. The other pilot agreed a disinvestment decision on the basis of evidence and reallocated the resources to a higher value service. The HB commissioning team found the information from the PBMA ‘journey’ as useful as the recommendations. A PBMA framework for the HB was devised. A ‘Prudent PBMA’ framework trimmed back to the critical essentials enables success criteria to be met. PBMA is to be adopted as a ‘way of working’ to operationalize resource reallocation and disinvestment in the ‘real world’ of Welsh healthcare commissioning.
published_date 2018-01-12T03:52:04Z
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