Allocative efficiency (better known as 'how will we pay for this?')
How can integrated care systems best allocate resources to make the biggest impact on population health? The Smarter Spending in Population Health (SSPH) programme supports Integrated Care Systems (ICSs) and other organisations involved in the delivery of care to find the most impactful areas to focus resources and make those changes happen.
SSPH brings together clinicians, patients and system leaders and helps them use analytical techniques to identify where the most effective changes could be made.
The programme is led by the Midlands Decision Support Network (MDSN), in partnership with the Strategy Unit (SU) and the Health Economics Unit (HEU) and, on this page, you can learn more about the training we’re delivering, find useful resources and contact us to get involved.
Working to improve COPD patient pathways
The first patient pathway we have been assessing is that of people living with Chronic Obstructive Pulmonary Disease (COPD). Working alongside five ICSs, the team is improving patient outcomes for the disease by gathering evidence on the following:
As part of this work, ICSs worked in teams to conduct a Discrete Choice Experiments (DCEs) survey, which was distributed to COPD patients across the country to ask about their preferences for care delivery. This was one of the largest DCE surveys ever conducted with COPD patients, receiving nearly 500 patient responses.
The STAR method
Through the SSPH programme we teach the Socio-technical Allocation of Resource (STAR) method of allocative efficiency. This method helps decision-makers to effectively assess their resources to see how they can create more value – crucially without spending more money.
You can learn more about the STAR method in this short video by Gwyn Bevan, STAR creator and London School of Economics (LSE) professor.
Health economist Jack Ettinger and consultant Luca Ricci-Pacifici, from the Health Economics Unit, explain the benefits of this population health management technique below.
Now you know the theory, how can you implement these insights into complex integrated care systems and their budgets? Nigel Edwards, CEO of the Nuffield Trust, shares his expert experience on turning theory into reality.
Keen to hear more about the Smarter Spending in Population Health programme?
Healthcare Analytics Leader | 20+ Years in NHS | Expert in Population Health Management & Data-Driven Insights
4 天前I remember working with Gwyn on Star ratings and his Star approach to allocative efficiency is very interesting. While leveraging the gradient of a cost-benefit line to maximise value in healthcare can help guide decision-making, it’s essential to critically examine the measures we use to evaluate "benefit," particularly QALYs. QALYs can undervalue interventions for populations with chronic illnesses or disabilities, as these individuals may not achieve the same "full health" baseline assumed in QALY calculations. This raises ethical concerns about equity in resource allocation—are we implicitly devaluing lives by prioritising those more likely to achieve higher QALY gains? Additionally, focusing resources on demographics that respond better to specific treatments could exacerbate health inequalities. For example, if data suggests a treatment is most effective in a younger population, would allocating more resources there lead to neglect of older patients, even though their needs are equally valid? Looking forward to meeting you tomorrow.