Using programme budgeting and marginal analysis to assist population basedstrategic planning for coronary heart disease

Objectives: the objective of this project was to use programme budgeting an d marginal analysis (PBMA), to inform the planning process of the South Wes tern Sydney Area Health Service (SWSAHS) in respect of coronary heart disea se (CHD). Methods: a working party was established to carry out the project . The group; set the parameters of the project and identified the programme , and associated the activity and resource use. Three sub-groups were estab lished to undertake the marginal analysis. Results: each sub-group (represe nting prevention, treatment, and rehabilitation for CHD) developed a list o f potential strategies and provided estimates of resource use and consequen ces. These were prioritised and presented as recommendations to the SWSAHS. Some recommendations required enhancement funding for the SWSAHS. Conclusi ons: while the use of PBMA presented some challenges, there were also some important outcomes. A comprehensive and detailed picture of resource use en abled the participants to form a view on how additional or reduced resource s for CHD should be dealt with at the area level. The ultimate recommendati ons represent involvement by key stakeholders in the SWSAHS planning proces s, not just in identifying the 'vision' of CHD services, but also, how serv ice delivery would be organised to achieve the overall objectives of reduci ng CHD morbidity and mortality. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.