Open Collections

UBC Faculty Research and Publications

Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority Mitton, Craig, 1972-; Dionne, Francois; Damji, Rizwan; Campbell, Duncan; Bryan, Stirling

Abstract

Objectives: The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods: A standard approach to program budgeting and marginal analysis (PBMA) was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results: The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion: A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement.

Item Metadata

Title
Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority
Creator
Mitton, Craig, 1972-; Dionne, Francois; Damji, Rizwan; Campbell, Duncan; Bryan, Stirling
Contributor
Centre for Clinical Epidemiology and Evaluation
Publisher
BioMed Central
Date Issued
2011-07-14
Description
Objectives: The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods: A standard approach to program budgeting and marginal analysis (PBMA) was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results: The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion: A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement.
Subject
priority setting; health care decision-making; disinvestment
Genre
Article
Type
Text
Language
eng
Date Available
2016-01-18
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0223748
URI
http://hdl.handle.net/2429/56575
Affiliation
Population and Public Health (SPPH), School of; Non UBC; Medicine, Faculty of
Citation
BMC Health Services Research. 2011 Jul 14;11(1):169
Publisher DOI
10.1186/1472-6963-11-169
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
Mitton et al; licensee BioMed Central Ltd.
Rights URI
http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository
DSpace

Item Media

Item Citations and Data

Rights

Attribution 4.0 International (CC BY 4.0)