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Preventive health resource allocation decision-making processes and the use of economic evidence in an Australian state government—A mixed methods study

Version 3 2024-06-14, 11:16
Version 2 2024-06-04, 12:44
Version 1 2023-02-08, 22:53
journal contribution
posted on 2024-06-14, 11:16 authored by Jaithri AnanthapavanJaithri Ananthapavan, Gary SacksGary Sacks, Marj MoodieMarj Moodie, Phuong NguyenPhuong Nguyen, Rob CarterRob Carter
Context Recommended best practice for resource allocation decisions by governments include a stepwise process guided by economic evidence. However, the use of economic evidence in preventive health decision-making, which often impacts on multiple sectors of government, is under-researched. This study aimed to explore the resource allocation decision-making processes for preventive health interventions in the New South Wales (NSW) Government in Australia, and specifically examined the barriers and facilitators to the use of economic evidence from the perspective of multiple government departments. Methods This mixed methods study was conducted using semi-structured interviews with NSW Treasury representatives (n = 4), a focus group of NSW Ministry of Health representatives (n = 9), and a quantitative questionnaire of all participants. The schedule for the interviews and focus group was based on resource allocation guidance documents from Australian government agencies. Deductive content analysis was undertaken, guided by the Multiple Streams Framework. Findings NSW Treasury participants believed that decision-making processes where economic efficiency was the key guiding principle was the ideal approach. However, the NSW Ministry of Health participants identified that for preventive health decision-making, economic evidence was not used to inform their own choices but was typically only used to convince other agencies of the merits of proposed initiatives when seeking approval. The key barriers to the use of economic evidence were the lack of capacity within the NSW Ministry of Health to understand and undertake economic evaluations; a lack of collaboration between NSW Treasury and preventive health decision-makers within the NSW Ministry of Health; and deficient processes and governance mechanisms that do not facilitate or incentivise effective inter-sectoral decision-making. Conclusions Institutional structures for resource allocation decision-making regarding preventive health result in processes that contrast with best practice recommendations. The multiple challenges to collaborative decision-making across agencies require organisational change to promote a whole-of-government approach.

History

Journal

PLoS ONE

Volume

17

Pagination

e0274869-e0274869

Location

United States

ISSN

1932-6203

eISSN

1932-6203

Language

en

Publication classification

C1 Refereed article in a scholarly journal

Editor/Contributor(s)

Donlan J

Issue

9 September

Publisher

Public Library of Science (PLoS)

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