Health care priority setting in Norway a multicriteria decision analysis

Thierry Defechereux, Francesco Paolucci, Andrew Mirelman, Sitaporn Youngkong, Grete Botten, Terje P Hagen, Louis W Niessen

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background:
Priority setting in population health is increasingly based on explicitly formulated values. The Patients Rights Act of the Norwegian tax-based health service guaranties all citizens health care in case of a severe illness, a proven health benefit, and proportionality between need and treatment. This study compares the values of the country's health policy makers with these three official principles.

Methods:
In total 34 policy makers participated in a discrete choice experiment, weighting the relative value of six policy criteria. We used multi-variate logistic regression with selection as dependent valuable to derive odds ratios for each criterion. Next, we constructed a composite league table - based on the sum score for the probability of selection - to rank potential interventions in five major disease areas.

Results:
The group considered cost effectiveness, large individual benefits and severity of disease as the most important criteria in decision making. Priority interventions are those related to cardiovascular diseases and respiratory diseases. Less attractive interventions rank those related to mental health.

Conclusions:
Norwegian policy makers' values are in agreement with principles formulated in national health laws. Multi-criteria decision approaches may provide a tool to support explicit allocation decisions.
Original languageEnglish
Article number39
JournalBMC Health Services Research
Volume12
DOIs
Publication statusPublished - 15 Feb 2012

Keywords

  • Age Factors
  • Cardiovascular Diseases
  • Choice Behavior
  • Cost-Benefit Analysis
  • Decision Making
  • Decision Support Techniques
  • Health Care Rationing
  • Health Policy
  • Health Priorities
  • Humans
  • Logistic Models
  • Needs Assessment
  • Norway
  • Policy Making
  • Quality-Adjusted Life Years
  • Respiratory Tract Diseases
  • Severity of Illness Index

Cite this