This paper identifies key political and technical issues involved in the development of an appropriate resource allocation and budgetary system for the public health sector, using experience gained in the Province of Balochistan, Pakistan. The resource allocation and budgetary system is a critical, yet often neglected, component of any decentralization policy. Current systems are often based on...

This article provides an analysis of the Scottish Government’s approach to the use of private finance in public services. It examines the budgetary drivers behind the policy in Scotland and assesses its cost-efficiency. In doing so, it considers first the standard private finance initiative (PFI) model, and then turns to the ‘non-profit distributing’ (NPD)model – a variant of PFI developed in S...

8.1 Two Research Conundrums..................................................................................................134 8.1.1 Lindblom’s Theory of Administrative Incrementalism...........................................134 8.1.2 Wildavsky’s Theory of Budgetary Incrementalism.................................................135 8.1.3 The Diverse Meanings of Budgetary “Incrementalism”.......

We develop a finite-horizon discrete-time constrained Markov decision process (MDP) to model diagnostic decisions after mammography where we maximize the total expected quality-adjusted life years (QALYs) of a patient under resource constraints. We use clinical data to estimate the parameters of the MDP model and solve it as a mixed-integer program. By repeating optimization for a sequence of b...