Programme Budgeting – Testing The Approach in Scotland
This paper describes the pilot application of Programme Budgeting and Marginal Analysis (PBMA) in Scotland. Within the Health Care Quality Strategy for NHSScotland one of the three quality ambitions is concerned with providing a more efficient and effective health service. This paper supports this ambition by discussing how outcome measures could be used, along with cost data disaggregated in this way, to inform discussions around the value for money associated with different programmes.
Footnotes
1. The Scottish Government, May 2010. The Healthcare Quality Strategy for NHSScotland
2. Mitton, C; Donaldson, C. (2001)
3. Martin S, Rice N & Smith PC. (2008)
4. Scottish Parliament Finance Committee's Inquiry into Preventative Spend
5. NHSScotland Programme Budgeting Methodology 2007/08 data, ISD Scotland, February 2010.
6. Secondary prevention relates to activities which decrease the chance of development of diseases in those with the relevant risk factor. For example, preventative interventions in those who are overweight and obese may reduce the chance of developing type 2 diabetes.
7. NAO 2001
8. NHS IC 2009
9. Each hospital discharge can include up to six diagnoses. The diagnosis / condition which appears first in the discharge record is known as the underlying or primary diagnosis, while conditions in any other position are supplementary diagnoses
10. ISD data: summary activity data disaggregated from category summaries by data request
11. ISD data: Summary activities at specialist outpatient clinics
12. ISD data: Cost book tables R040 and R044
13. ISD data: Prescription cost analysis for Scotland
14. ISD data: Prescribing of Smoking Cessation Interventions
15. York University 2010
16. There is a separate data collection in ISD for CAMHS and not all will be included on SMR04. This separate CAMHS dataset has not been included in any of the analyses presented.
17. This last group of cancers could push up the apparent incidence of cancer for less deprived areas, suggesting that the "true" social differential for incidences of cancer is even greater than headline figures suggest.
18. 'Healthy individuals group' represents expenditure on disease prevention and 'social care needs' reflects the cost of social support,
19. http://www.dh.gov.uk/en/Managingyourorganisation/Financeandplanning/Programmebudgeting/DH_075743
20. Stephen Martin, Nigel Rice, & Peter C Smith. (2008) The link between health care spending and health outcomes for the new English Primary Care Trusts. CHE Discussion Paper. University of York
21. The HRG grouper assigns HRG codes and PBC codes based on diagnostic/procedural information as well as other variables
22. http://www.dh.gov.uk/en/Managingyourorganisation/Financeandplanning/Programmebudgeting/index.htm
Contact
Email: Marjorie Marshall
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