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Participatory health system priority setting: evidence from a budget experiment

Costa-Font, Joan ORCID: 0000-0001-7174-7919, Forns, Joan Rovira and Sato, Azusa (2015) Participatory health system priority setting: evidence from a budget experiment. Social Science & Medicine, 146. pp. 182-190. ISSN 0277-9536

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Identification Number: 10.1016/j.socscimed.2015.10.042


Budget experiments can provide additional guidance to heath system reform requiring the identification of a subset of programs and services that accrue the highest social value to ‘communities’. Such experiments simulate a realistic budget resource allocation assessment among competitive programs, and position citizens as decision makers responsible for making ‘collective sacrifices’. This paper explores the use of a participatory budget experiment (with 88 participants clustered in social groups) to model public health care reform, drawing from a set of realistic scenarios for potential health care users. We measure preferences by employing a contingent ranking alongside a budget allocation exercise (termed ‘willingness to assign’) before and after program cost information is revealed. Evidence suggests that the budget experiment method tested is cognitively feasible and incentive compatible. The main downside is the existence of ex-ante “cost estimation” bias. Additionally, we find that participants appeared to underestimate the net social gain of redistributive programs. Relative social value estimates can serve as a guide to aid priority setting at a health system level.

Item Type: Article
Official URL:
Additional Information: © 2015 Elsevier B.V.
Divisions: Social Policy
Subjects: H Social Sciences > H Social Sciences (General)
R Medicine > RA Public aspects of medicine
Date Deposited: 26 Oct 2015 09:17
Last Modified: 20 Oct 2021 00:50

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