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The rationale and design of public involvement in health-funding decision making: focus groups with the Canadian public

Published online by Cambridge University Press:  05 August 2020

Edilene Lopes Open the ORCID record for Edilene Lopes [Opens in a new window] ,
Jackie Street Open the ORCID record for Jackie Street [Opens in a new window] ,
Tania Stafinski ,
Tracy Merlin  and
Drew Carter
Edilene Lopes*
Affiliation:
Adelaide Health Technology Assessment, School of Public Health, The University of Adelaide, Adelaide, Australia
Jackie Street
Affiliation:
School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Mail Drop 545 or 511, Level 9, Adelaide Health & Medical Sciences Building, Adelaide, SA5005, Australia School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
Tania Stafinski
Affiliation:
Health Technology and Policy Unit, School of Public Health, University of Alberta, Edmonton, Canada
Tracy Merlin
Affiliation:
Adelaide Health Technology Assessment, School of Public Health, The University of Adelaide, Adelaide, Australia
Drew Carter
Affiliation:
Adelaide Health Technology Assessment, School of Public Health, The University of Adelaide, Adelaide, Australia
*
Author for correspondence: Edilene Lopes, E-mail: edilene.lopesmcinnes@adelaide.edu.au
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Abstract

Background

Worldwide, governments employ health technology assessment (HTA) in healthcare funding decision making. Requests to include public perspectives in this are increasing, with the idea being that the public can identify social values to guide policy development, increasing the transparency and accountability of government decision making.

Objective

To understand the perspectives of the Canadian public on the rationale and design of public involvement in HTA.

Design

A demographically representative sample of residents of a Canadian province was selected to take part in two sets of two focus groups (sixteen people for the first set and twenty for the second set).

Results

Participants were suspicious of the interests driving various stakeholders involved in HTA. They saw the public as uniquely impartial though also lacking knowledge about health technologies. Participants were also suspicious of personal biases and commended mechanisms to reduce their impact. Participants suggested various involvement methods, such as focus groups, citizens' juries and surveys, noting advantages and disadvantages belonging to each and commending a combination.

Discussion and conclusions

We identified a lack of public understanding of how decisions are made and distrust concerning whose interests and values are being considered. Public involvement was seen as a way of providing information to the public and ascertaining their views and values. Participants suggested that public involvement should employ a mixed-methods strategy to support informed debate and participation of a large number of people.

Keywords

Public involvementHealth technology assessmentSoft systems methodologyComplex adaptive systemFocus groups
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 6 , December 2020 , pp. 592 - 598
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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