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Institutional considerations in priority setting: transactions cost perspective on PBMA
Author(s) -
Jan Stephen
Publication year - 2000
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/1099-1050(200010)9:7<631::aid-hec531>3.0.co;2-n
Subject(s) - perspective (graphical) , incentive , sustainability , public economics , business , set (abstract data type) , operations management , actuarial science , economics , computer science , microeconomics , ecology , artificial intelligence , programming language , biology
Programme budgeting and marginal analysis (PBMA) is increasingly being used as a method of priority setting in the health care sector. Despite this, PBMA has, on occasions, been subject to problems in its application which can be seen as being ‘institutional’ in nature. This paper examines the extent to which the institutional setting of PBMA affects the way in which it can be conducted. In particular, a transactions costs perspective is taken to analyse the extent to which variation in such costs can alter the incentives of the individual participants. A number of recommendations for improving the sustainability of such projects is then provided. Following this, the implications which this ‘institutional’ approach has for the evaluation of PBMA are set out. Copyright © 2000 John Wiley & Sons, Ltd.