BACKGROUND The economic implications of major system change are an important component of the decision to implement health service reconfigurations. Little is known about how best to report the results of economic evaluations of major system change to inform decision-makers. Reconfiguration of acute stroke care in two metropolitan areas in England, namely London and Greater Manchester (GM), was...

Program budgeting and marginal analysis is a method of priority-setting in health care. This article describes how this method was applied to the management of a disease-specific group, chronic airflow limitation. A sub-program flow chart clarified the major cost drivers. After assessment of the technical efficiency of the sub-programs and careful and detailed analysis, incremental and decremen...

Healthcare technology is a two-edged sword - it offers new and better treatment to a wider range of people and, at the same time, is a major driver of increasing costs in health systems. Many countries have developed sophisticated systems of health technology assessment (HTA) to inform decisions about new investments in new healthcare interventions. In this paper, we question whether HTA is als...

Individual consumers often are assumed to follow certain relatively simple budgeting rules when making expenditure decisions. For example, how much to save may be decided upon almost separately from decisions on how much to spend on food, services, and other day-to-day consumables. Of course, it is well known that such "decentralized" budgeting decisions can fit well within standard consumer th...

The focus of health services in NSW has shifted from efficiency defined in terms of outputs to maximising health outcomes. The purpose of the health system is to deliver better health rather than more health services, and goals and targets for improving health are being determined for the main health problem areas. If the vision of a health system oriented towards achieving the best possible he...