Skip to main content
Top
Published in: BMC Health Services Research 1/2012

Open Access 01-12-2012 | Research article

Health care priority setting in Norway a multicriteria decision analysis

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

Published in: BMC Health Services Research | Issue 1/2012

Login to get access

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.
Literature
1.
go back to reference Peacock SRD, Mitton C, Donaldson C, Bate A, Murtagh M: Using economics to set pragmatic and ethical priorities. BMJ. 2006, 332 (7539): 482-485. 10.1136/bmj.332.7539.482.CrossRefPubMedPubMedCentral Peacock SRD, Mitton C, Donaldson C, Bate A, Murtagh M: Using economics to set pragmatic and ethical priorities. BMJ. 2006, 332 (7539): 482-485. 10.1136/bmj.332.7539.482.CrossRefPubMedPubMedCentral
2.
go back to reference Rob Baltussen LN: Priority setting of health interventions: the need for multi-criteria decision analysis. Cost Effectiveness Resource Allocation (CERA). 2006, 4: 14-10.1186/1478-7547-4-14.CrossRef Rob Baltussen LN: Priority setting of health interventions: the need for multi-criteria decision analysis. Cost Effectiveness Resource Allocation (CERA). 2006, 4: 14-10.1186/1478-7547-4-14.CrossRef
3.
go back to reference Esther w, De Bakker-Grob MR, Karen Gerard: Discrete choice experiments in health economics: a review of the literature. Health Econ. 2012, 2: 145-172. Esther w, De Bakker-Grob MR, Karen Gerard: Discrete choice experiments in health economics: a review of the literature. Health Econ. 2012, 2: 145-172.
4.
go back to reference Paul Scuffham JW, Matthew Taylor, Ruth Saxby: Health system choice-a pilot discrete-choice experiment eliciting the preferences of British and Australian citizens. Appl Health Econ Health Policy. 2010, 8: 89-97. 10.2165/11531170-000000000-00000.CrossRefPubMed Paul Scuffham JW, Matthew Taylor, Ruth Saxby: Health system choice-a pilot discrete-choice experiment eliciting the preferences of British and Australian citizens. Appl Health Econ Health Policy. 2010, 8: 89-97. 10.2165/11531170-000000000-00000.CrossRefPubMed
5.
go back to reference Niessen LW GE, Rutten FF: The evidence-based approach in health policy and health care delivery. Soc Sci Med. 2000, 51 (6): 859-869. 10.1016/S0277-9536(00)00066-6.CrossRefPubMed Niessen LW GE, Rutten FF: The evidence-based approach in health policy and health care delivery. Soc Sci Med. 2000, 51 (6): 859-869. 10.1016/S0277-9536(00)00066-6.CrossRefPubMed
6.
go back to reference Noorani HZ HD, Boudreau R, Skidmore B: Priority setting for health technology assessments: a systematic review of current practical approaches. Int J Technol Assess Health Care. 2007, 23: 310-315.CrossRefPubMed Noorani HZ HD, Boudreau R, Skidmore B: Priority setting for health technology assessments: a systematic review of current practical approaches. Int J Technol Assess Health Care. 2007, 23: 310-315.CrossRefPubMed
7.
go back to reference Sitaporn Youngkong LK, Rob Baltussen: Setting priorities for health interventions in developing countries: a review of empirical studies. Trop Med Int Health. 2009, 14: 930-939. 10.1111/j.1365-3156.2009.02311.x.CrossRefPubMed Sitaporn Youngkong LK, Rob Baltussen: Setting priorities for health interventions in developing countries: a review of empirical studies. Trop Med Int Health. 2009, 14: 930-939. 10.1111/j.1365-3156.2009.02311.x.CrossRefPubMed
8.
go back to reference Ducan Mortimer LS: Is the value of a life or life-year saved context specific? Further evidence from a discrete choice experiment. Cost Effectiveness and Resource Allocation(CERA). 2008, 6: 8-10.1186/1478-7547-6-8.CrossRef Ducan Mortimer LS: Is the value of a life or life-year saved context specific? Further evidence from a discrete choice experiment. Cost Effectiveness and Resource Allocation(CERA). 2008, 6: 8-10.1186/1478-7547-6-8.CrossRef
9.
go back to reference Baeten Stefan A, Baltussen Rob, Uyl-de Groot Carin A, Bridges John, Niessen Louis W: Incorporating equity-efficiency interactions in cost-effectiveness analysis--three approaches applied to breast cancer control. Value Health. 2010, 13: 573-579. 10.1111/j.1524-4733.2010.00718.x.CrossRefPubMed Baeten Stefan A, Baltussen Rob, Uyl-de Groot Carin A, Bridges John, Niessen Louis W: Incorporating equity-efficiency interactions in cost-effectiveness analysis--three approaches applied to breast cancer control. Value Health. 2010, 13: 573-579. 10.1111/j.1524-4733.2010.00718.x.CrossRefPubMed
10.
go back to reference Morland Berit, Ringard Anen, Rottingen John-Arne: Supporting tough decisions in Norway: a healthcare system approach. Int J Technol Assess Health Care. 2010, 26: 398-404. 10.1017/S0266462310001030.CrossRefPubMed Morland Berit, Ringard Anen, Rottingen John-Arne: Supporting tough decisions in Norway: a healthcare system approach. Int J Technol Assess Health Care. 2010, 26: 398-404. 10.1017/S0266462310001030.CrossRefPubMed
11.
go back to reference OECD: OECD. StatExtracts. Health Status. 2011 OECD: OECD. StatExtracts. Health Status. 2011
12.
go back to reference Health systems in transition: Norway. Edited by: Johnsen J. 2006, Copenhagen: WHO regional Office for Europe on behalf of the European Observatory on health Systems and Policies Health systems in transition: Norway. Edited by: Johnsen J. 2006, Copenhagen: WHO regional Office for Europe on behalf of the European Observatory on health Systems and Policies
13.
go back to reference Baeten SA BR, Uyl-de Groot C, Bridges JFP, Niessen LW: Reducing Disparities in breast cancer survival - the effect of large-scale screening of the uninsured. Breast J. 2011, 17: 548-549. 10.1111/j.1524-4741.2011.01135.x.CrossRefPubMed Baeten SA BR, Uyl-de Groot C, Bridges JFP, Niessen LW: Reducing Disparities in breast cancer survival - the effect of large-scale screening of the uninsured. Breast J. 2011, 17: 548-549. 10.1111/j.1524-4741.2011.01135.x.CrossRefPubMed
14.
go back to reference Rob baltussen AtA, Koolman X, Shrestha N, Bhattari P, Niessen LW: Priority setting using multiple criteria: should a lung health programme be implemented in Nepal?. Health Policy Plan. 2007, 22: 178-185. 10.1093/heapol/czm010.CrossRef Rob baltussen AtA, Koolman X, Shrestha N, Bhattari P, Niessen LW: Priority setting using multiple criteria: should a lung health programme be implemented in Nepal?. Health Policy Plan. 2007, 22: 178-185. 10.1093/heapol/czm010.CrossRef
15.
go back to reference Rob Baltussen ES, Dan Chisholm, Moss Aikins: Towards a multi-criteria approach for priority setting: an application to Ghana. Health Econ. 2006, 15: 689-696. 10.1002/hec.1092.CrossRefPubMed Rob Baltussen ES, Dan Chisholm, Moss Aikins: Towards a multi-criteria approach for priority setting: an application to Ghana. Health Econ. 2006, 15: 689-696. 10.1002/hec.1092.CrossRefPubMed
16.
go back to reference Mangham KH, Lindsay J, Barbara McPake: How to do (or not to do)... designing a discrete choice experiment for application in a low-income country. Health Policy Plan. 2009, 24: 151-158. 10.1093/heapol/czn047.CrossRefPubMed Mangham KH, Lindsay J, Barbara McPake: How to do (or not to do)... designing a discrete choice experiment for application in a low-income country. Health Policy Plan. 2009, 24: 151-158. 10.1093/heapol/czn047.CrossRefPubMed
17.
go back to reference Mandy Ryan KG, Mabel Amaya-Amaya: Using Discrete Choice Experiments to Value Health and Health Care. 2008, Dordrecht: Springer, 1CrossRef Mandy Ryan KG, Mabel Amaya-Amaya: Using Discrete Choice Experiments to Value Health and Health Care. 2008, Dordrecht: Springer, 1CrossRef
18.
go back to reference Marc A, Koopmanschap EAS, Xander Koolman: Dear policy maker: have you made up your mind? A discrete choice experiment among policy makers and other health professionals. Int J Technol Assess Health Care. 2010, 26 (2): 198-204. 10.1017/S0266462310000048.CrossRef Marc A, Koopmanschap EAS, Xander Koolman: Dear policy maker: have you made up your mind? A discrete choice experiment among policy makers and other health professionals. Int J Technol Assess Health Care. 2010, 26 (2): 198-204. 10.1017/S0266462310000048.CrossRef
20.
go back to reference 2011-2015 MeldSt.16: National plan for health and care services (2011-2015). Nasjonal helse- og omsorgsplan. 2011, Oslo: (2011-2015) Helse-OG-Omsorgsdepartementet, 2010-2011, -2015 2011-2015 MeldSt.16: National plan for health and care services (2011-2015). Nasjonal helse- og omsorgsplan. 2011, Oslo: (2011-2015) Helse-OG-Omsorgsdepartementet, 2010-2011, -2015
21.
go back to reference Kapiriri L, Norheim OF, Martin DK: Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making?. Soc Sci Med. 2009, 68: 766-773. 10.1016/j.socscimed.2008.11.011.CrossRefPubMed Kapiriri L, Norheim OF, Martin DK: Fairness and accountability for reasonableness. Do the views of priority setting decision makers differ across health systems and levels of decision making?. Soc Sci Med. 2009, 68: 766-773. 10.1016/j.socscimed.2008.11.011.CrossRefPubMed
22.
go back to reference Kunnskapssenteret NKcfths-: OECD Press release, Oslo Dec 2009. 2009 Kunnskapssenteret NKcfths-: OECD Press release, Oslo Dec 2009. 2009
23.
go back to reference Colin Green KG: Exploring the social value of health care interventions: a stated preference discrete choice experiment. Health Econ. 2009, 18 (8): 951-976. 10.1002/hec.1414.CrossRefPubMed Colin Green KG: Exploring the social value of health care interventions: a stated preference discrete choice experiment. Health Econ. 2009, 18 (8): 951-976. 10.1002/hec.1414.CrossRefPubMed
Metadata
Title
Health care priority setting in Norway a multicriteria decision analysis
Authors
Thierry Defechereux
Francesco Paolucci
Andrew Mirelman
Sitaporn Youngkong
Grete Botten
Terje P Hagen
Louis W Niessen
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2012
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-12-39

Other articles of this Issue 1/2012

BMC Health Services Research 1/2012 Go to the issue