Abstract

Background: The burden of mental disorder is expected to be the highest ranked cause of disease in high income countries by 2020. Facing changing health needs, policy makers need to make choices between competing demands and their resource allocation. Multi-criteria decision analysis (MCDA) has been identified as an approach to support and rationalize decision making in health care systems.

Methods: 70 respondents participated in a discrete choice experiment to determine the relative importance of efficiency and equity criteria deemed relevant in the context of decision making. Half of them were policy makers, others were researcher and health care worker. Data was collected by a modified mailed questionnaire method. Regression analysis was used to derive odds ratios for each criterion. Health interventions selected from the burden of diseases in Austria were ranked in a composite league table (CLT) – an application of the MCDA approach, based on these criteria and associated weights.

Results: The analyzed policy maker’s preference weights displayed that efficiency criteria are proportionally more likely to be included into decision making than equitable ones. High priority interventions are related to the growing burden of mental disorders and non-communicable diseases. Lower priority was given to preventive health interventions.

Conclusion and policy implications: Mental health is a sensitive area of health care decision making as lots of macrodeterminants are influenced by almost all governance sectors. MCDA might offer a complementary tool to aid decision making.

Slides