205426 Using resources wisely: Prioritization criteria for decision-making in a local health department

Monday, November 9, 2009: 10:30 AM

Jeffrey D. Gunzenhauser, MD, MPH , Division of Quality Improvement, Los Angeles County, Los Angeles, CA
Kathleen N. Smith, PHN, MSN, MPH , Division of Quality Improvement, Office of the Medical Director, Los Angeles County Public Health, Los Angeles, CA
Jonathan Fielding, MD, MPH , Department of Public Health, Los Angeles County, Los Angeles, CA
Public health faces the challenge of unlimited opportunities to improve the public's health in an environment that is unavoidably short of resources. This reality requires local health departments to review, analyze, and prioritize among these opportunities. A deliberate, well-conceived method of prioritization would assure the best use of scarce resources and demonstrate good stewardship of public funds. Lack of consensus on the need for or content of a specific priority-setting method inevitably results in ad hoc decision-making based on intuition and may leave the allocation of public resources vulnerable to political expediency or unethical intentions. A flexible, yet comprehensive multi-domain approach to priority-setting affords numerous benefits including: applicability to the broad scope of public health work, a transparent process that supports accountability, and a rational approach that anticipates key considerations in public health planning. Key considerations in any prioritization effort include not only measures of disease burden and preventability, but also issues of intervention effectiveness, efficiency and acceptability, as well as consideration of various important, external factors. This presentation outlines the work of the Los Angeles County Department of Public Health in developing a set of priority-setting criteria for use within the department.

Learning Objectives:
Describe four domains that should be considered in prioritizing the work of public health

Keywords: Public Health Administration, Decision-Making

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As the Medical Director, and Director of Quality Improvement for the the Los Angeles County Department of Public Health, I am frequently involved in strategic decision-making efforts, and have had experience in apply various criteria in this area. I have reviewed the literature in this area, as an aid to our local efforts, and believe the approach we are recommending can be of value to many.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.