Decision Making in Health Care: Exploring Cost Variability

Decisions of Value: Going Backstage; Comment on “Contextual Factors Influencing Cost and Quality Decisions in Health and Care: A Structured Evidence Review and Narrative Synthesis”

This commentary expands on two of the key themes briefly raised in the paper involving analysis of the evidence about key contextual influences on decisions of value. The first theme focuses on the need to explore in more detail what is called backstage decision-making looking at how actual decisions are made drawing on evidence from ethnographies about decision-making. These studies point to l...

Use of Cost-Effectiveness Data in Priority Setting Decisions: Experiences from the National Guidelines for Heart Diseases in Sweden

Background The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority ran...

Understanding Contextual Factors in Cost, Quality and Priority Setting Decisions in Health; Comment on “Contextual Factors Influencing Cost and Quality Decisions in Health and Care: A Structured Evidence Review and Narrative Synthesis”

There is growing recognition in the academic literature that critical decisions concerning resource allocation and resource management in health and care are influenced by a range of contextual factors. In their paper in this journal, Williams et al define these ‘decisions of value’ as being characterized by a significant and demonstrable impact on quality and resources in health and care. ‘Dec...

Including Both Costs and Effects – The Challenge of Using Cost-Effectiveness Data in National-Level Policy-Making: A Response to Recent Commentaries

Contextual Factors Influencing Cost and Quality Decisions in Health and Care: A Structured Evidence Review and Narrative Synthesis

Background Decisions affecting cost and quality are taken across health and care but investigation of the mediating role of context in these is in its infancy. This paper presents a synthesis of the evidence on the contextual factors that influence ‘decisions of value’ – defined as those characterised by having a significant and demonstrable impact on both quality and resources – in health and ...