Abstract
BackgroundResource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons.MethodsBetween January and April 2011, we conducted an on-line survey of senior decision makers within regional health authorities (and closely equivalent organizations) across all Canadian provinces and territories. We received returns from 92 individual managers, from 60 out of 89 organizations in total. The survey inquired about structures, process features, and behaviours related to organization-wide resource allocation decisions. We focus here on three main aspects: type of process, perceived fairness, and overall rating.ResultsAbout one-half of respondents indicated that their organization used a formal process for resource allocation, while the others reported that political or historical factors were predominant. Seventy percent (70%) of respondents self-reported that their resource allocation process was fair and just over one-half assessed their process as ‘good’ or ‘very good’. This paper explores these findings in greater detail and assesses them in context of the larger literature.ConclusionData from this large-scale cross-jurisdictional survey helps to illustrate common challenges and areas of positive performance among Canada’s health system leadership teams.
Highlights
Resource allocation is a key challenge for healthcare decision makers
We know that priority setting and resource allocation processes need to be both economically sound and ethical –fair and transparent [1,2,3]
We focus on descriptive findings related to three research questions: 1. What type of resource allocation processes are used by Canadian healthcare organizations? Literature suggests that in Canada and elsewhere, healthcare organizations typically allocate resources on the basis of historical patterns –‘locking in’ to past budget choices [26] -- and/or political rationales [7,33,34], and there are powerful institutional and cultural reasons why this is so [35,36]
Summary
Resource allocation is a key challenge for healthcare decision makers. While several case studies of organizational practice exist, there have been few large-scale cross-organization comparisons. Resource allocation is a central function of all healthcare delivery systems. Our knowledge has accumulated largely through case studies of individual organizations, in Canada [16,17,18,19,20,21,22] and elsewhere [23,24,25]. Because primary constitutional authority for organization of healthcare delivery systems in Canada rests with the provincial and territorial jurisdictions, a pan-Canadian survey could potentially be a very rich source of information on political, institutional and cultural factors that influence resource allocation efforts among senior managers with service delivery responsibility
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