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STAR — people-powered prioritization: a 21st-century solution to allocation headaches

Airoldi, Mara and Morton, Alec and Bevan, Gwyn and Smith, Jennifer (2014) STAR — people-powered prioritization: a 21st-century solution to allocation headaches. Medical Decision Making, 34 (8). pp. 965-975. ISSN 1552-681X

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Identification Number: 10.1177/0272989X14546376

Abstract

The aim of cost effectiveness analysis (CEA) is to inform the allocation of scarce resources. CEA is routinely used in assessing the cost-effectiveness of specific health technologies by agencies such as the National Institute for Health and Clinical Excellence (NICE) in England and Wales. But there is extensive evidence that because of barriers of accessibility and acceptability, CEA has not been used by local health planners in their annual task of allocating fixed budgets to a wide range of types of health care. This paper argues that these planners can use Socio Technical Allocation of Resources (STAR) for that task. STAR builds on the principles of CEA and the practice of program budgeting and marginal analysis. STAR uses requisite models to assess the cost-effectiveness of all interventions considered for resource reallocation by explicitly applying the theory of health economics to evidence of scale, costs, and benefits, with deliberation facilitated through an interactive social process of engaging key stakeholders. In that social process, the stakeholders generate missing estimates of scale, costs, and benefits of the interventions; develop visual models of their relative cost-effectiveness; and interpret the results. We demonstrate the feasibility of STAR by showing how it was used by a local health planning agency of the English National Health Service, the Isle of Wight Primary Care Trust, to allocate a fixed budget in 2008 and 2009.

Item Type: Article
Official URL: http://mdm.sagepub.com/
Additional Information: © 2014 The Author
Subjects: H Social Sciences > H Social Sciences (General)
H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Sets: Departments > Management
Research centres and groups > Public Management Group
Research centres and groups > Centre for Analysis of Risk and Regulation (CARR)
Research centres and groups > LSE Health
Date Deposited: 04 Dec 2014 12:53
Last Modified: 12 Dec 2014 14:00
Funders: The Health Foundation (Registered Charity 286967)
URI: http://eprints.lse.ac.uk/id/eprint/51299

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