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Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature
Background: Decentralization of health systems has made sub-national/regional healthcare systems the backbone of healthcare delivery. These regions are tasked with the difficult responsibility of determining healthcare priorities and resource allocation amidst scarce resources. We aimed to review em...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
F1000 Research Limited
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5814743/ https://www.ncbi.nlm.nih.gov/pubmed/29511741 http://dx.doi.org/10.12688/wellcomeopenres.13393.2 |
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author | Waithaka, Dennis Tsofa, Benjamin Barasa, Edwine |
author_facet | Waithaka, Dennis Tsofa, Benjamin Barasa, Edwine |
author_sort | Waithaka, Dennis |
collection | PubMed |
description | Background: Decentralization of health systems has made sub-national/regional healthcare systems the backbone of healthcare delivery. These regions are tasked with the difficult responsibility of determining healthcare priorities and resource allocation amidst scarce resources. We aimed to review empirical literature that evaluated priority setting practice at the meso (sub-national) level of health systems. Methods: We systematically searched PubMed, ScienceDirect and Google scholar databases and supplemented these with manual searching for relevant studies, based on the reference list of selected papers. We only included empirical studies that described and evaluated, or those that only evaluated priority setting practice at the meso-level. A total of 16 papers were identified from LMICs and HICs. We analyzed data from the selected papers by thematic review. Results: Few studies used systematic priority setting processes, and all but one were from HICs. Both formal and informal criteria are used in priority-setting, however, informal criteria appear to be more perverse in LMICs compared to HICs. The priority setting process at the meso-level is a top-down approach with minimal involvement of the community. Accountability for reasonableness was the most common evaluative framework as it was used in 12 of the 16 studies. Efficiency, reallocation of resources and options for service delivery redesign were the most common outcome measures used to evaluate priority setting. Limitations: Our study was limited by the fact that there are very few empirical studies that have evaluated priority setting at the meso-level and there is likelihood that we did not capture all the studies. Conclusions: Improving priority setting practices at the meso level is crucial to strengthening health systems. This can be achieved through incorporating and adapting systematic priority setting processes and frameworks to the context where used, and making considerations of both process and outcome measures during priority setting and resource allocation. |
format | Online Article Text |
id | pubmed-5814743 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | F1000 Research Limited |
record_format | MEDLINE/PubMed |
spelling | pubmed-58147432018-03-05 Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature Waithaka, Dennis Tsofa, Benjamin Barasa, Edwine Wellcome Open Res Systematic Review Background: Decentralization of health systems has made sub-national/regional healthcare systems the backbone of healthcare delivery. These regions are tasked with the difficult responsibility of determining healthcare priorities and resource allocation amidst scarce resources. We aimed to review empirical literature that evaluated priority setting practice at the meso (sub-national) level of health systems. Methods: We systematically searched PubMed, ScienceDirect and Google scholar databases and supplemented these with manual searching for relevant studies, based on the reference list of selected papers. We only included empirical studies that described and evaluated, or those that only evaluated priority setting practice at the meso-level. A total of 16 papers were identified from LMICs and HICs. We analyzed data from the selected papers by thematic review. Results: Few studies used systematic priority setting processes, and all but one were from HICs. Both formal and informal criteria are used in priority-setting, however, informal criteria appear to be more perverse in LMICs compared to HICs. The priority setting process at the meso-level is a top-down approach with minimal involvement of the community. Accountability for reasonableness was the most common evaluative framework as it was used in 12 of the 16 studies. Efficiency, reallocation of resources and options for service delivery redesign were the most common outcome measures used to evaluate priority setting. Limitations: Our study was limited by the fact that there are very few empirical studies that have evaluated priority setting at the meso-level and there is likelihood that we did not capture all the studies. Conclusions: Improving priority setting practices at the meso level is crucial to strengthening health systems. This can be achieved through incorporating and adapting systematic priority setting processes and frameworks to the context where used, and making considerations of both process and outcome measures during priority setting and resource allocation. F1000 Research Limited 2018-02-20 /pmc/articles/PMC5814743/ /pubmed/29511741 http://dx.doi.org/10.12688/wellcomeopenres.13393.2 Text en Copyright: © 2018 Waithaka D et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Systematic Review Waithaka, Dennis Tsofa, Benjamin Barasa, Edwine Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature |
title | Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature |
title_full | Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature |
title_fullStr | Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature |
title_full_unstemmed | Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature |
title_short | Evaluating healthcare priority setting at the meso level: A thematic review of empirical literature |
title_sort | evaluating healthcare priority setting at the meso level: a thematic review of empirical literature |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5814743/ https://www.ncbi.nlm.nih.gov/pubmed/29511741 http://dx.doi.org/10.12688/wellcomeopenres.13393.2 |
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