What drives health-care spending priorities? An international survey of health-care professionals

Making the rules of health-care resource allocation transparent is a challenge for all governments. The Oregon Health Plan in the late 1980s was one such attempt to prioritise expenditure of limited Medicaid funds, based on public values. For decision makers, asking the general public and health professionals to express their preferences for health-care spending priorities can be a way of ensuring that the process and resultant spending priorities are seen as legitimate and fair. In a study comparing the preferences of health professionals and members of the public for setting health-care priorities, Wiseman found considerable uniformity in preferences between the two groups. However, some members of the public argued that it would be better to trust health professionals to make the correct decision in the first place. The purpose of this study is to compare spending priorities for health care across a selection of predominantly middle-income countries, based on the opinions of current and future decision makers. Using an opinion poll questionnaire, we surveyed 253 health professionals from six countries, asking them to rank ten health interventions in order of priority for spending from most important (rank 1) to least important (rank 10). The questionnaire was based on a short questionnaire on priorities for health-care spending developed by Groves.