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 Communiti...

Introduction Disinvestment of ineffective, low value technologies is growing as a priority for international health policy in order to improve quality and maximize care. Different strategies have been implemented at the national level using various methods evidence gathering technical assessment. However, success these initiatives mixed, with fewer than half empirical studies reporting reductio...

The economic framework, ‘Program Budget Marginal Analysis’ (PBMA) has been used by health care managers internationally to help set priorities and allocate resources within and across programs of care. The authors describe the use of the PBMA framework to guide a pilot project aimed at improving surgical services utilization in a regional hospital in a Western Canadian health region. The focus ...

Acknowledgements The author is grateful for financial support from the NICE Decision Support Unit (DSU). NICE had no responsibility or control over the content of this paper. This paper aims to look at the applicability of multi criteria decision analysis (MCDA) for health technology assessment. MCDA is aimed at supporting decision makers faced with evaluating alternatives, taking into account ...

BACKGROUND The Health-sector Wide (HsW) priority setting model is designed to shift the focus of priority setting away from 'program budgets'--that are typically defined by modality or disease-stage--and towards well-defined target populations with a particular disease/health problem. METHODS The key features of the HsW model are i) a disease/health problem framework, ii) a sequential approac...