Priority setting in health care using multi-attribute utility theory and programme budgeting and marginal analysis (PBMA)

Programme budgeting and marginal analysis (PBMA) is becoming an increasingly popular tool in setting health service priorities. This paper presents a novel multi-attribute utility (MAU) approach to setting health service priorities using PBMA. This approach includes identifying the attributes of the MAU function; describing and scaling attributes; quantifying trade-offs between attributes; and combining single conditional utility functions into the MAU function. We illustrate the MAU approach using a PBMA case study in mental health services from the Community Health Sector in metropolitan South Australia. Keywords: Priority setting; Programme budgeting; Marginal analysis; Decision analysis; Multi-attribute utility theory; Mental health; Australia