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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Health care priority setting in Norway a multicriteria decision analysis

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Thierry Defechereux, Francesco Paolucci, Andrew Mirelman, Sitaporn Youngkong, Grete Botten, Terje P Hagen, Louis W Niessen
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

TD: Drafted the manuscript, carried out data extraction and analysis. FP: designed, conceived and coordinated the study, reviewed the draft. AM: contributed to the extraction, analysis and interpretation of the data, reviewed the draft. SY: contributed to the extraction, analysis and interpretation of the data. GB: contributed to the analysis and interpretation of the data. TH: Drafted the manuscript, collected the data, contributed to the analysis and interpretation of the data. LN: designed and conceived the study, contributed to the analysis and reviews. All authors read and approved the final manuscript.

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.
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