Budget auditing: a process to assist planning for health promotion services

Abstract

Issues addressed: Using the concepts of program budgeting and marginal analysis (PBMA), the South Eastern Sydney Health Promotion Service conducted a budget audit to inform future planning. PBMA is an economic tool that examines relationships between services, costs, outputs and outcomes for health. Method: The goals, objectives and process and intermediate outcomes of program areas were summarised. Staff time spent on different activities was estimated, and goods and services budgets calculated. Staff suggested changes to programs and operations, given a 5% and 33% increase, and 5% and 33% decrease in funding. To assist informed decision making, information on good practice, local data and other relevant material was provided. Results were collated, themes identified and discussed and recommendations for change made. Results: Program budgets accounted for 61% of total funds; the remainder was spent on specialist support, administration and operational costs. Three programs (nutrition, physical activity and capacity building) each received more than 20% of the program funding, and four (tobacco, sun, falls and schools) each received less than 10%. Projects within the health service, school and child care settings received the most resources; initiatives for Aboriginal people received the least. Conclusions: The process led to changes in program funding (increased resources to tobacco and Aboriginal health at the expense of sun protection and capacity building) and informed the new health promotion strategic plan. (author abstract)