Priority Setting in Health and Social Care

This report discusses the importance of priority setting in health and social care. It explores the scale of the problem, determinants of health, and government priorities. It also provides potential strategies for improvement.

Running head: REPORT
Assessment 2: Priority setting exercise
Name of the Student
Name of the University
Author Note

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Executive summary
Priority setting in health and social care is associated with processes that help in arriving at
resolutions about the distribution of resources to classify and address significant health
concerns. Prioritisation of healthcare resources can generally operate at micro-level for
individual programs, meso-level for communities and local catchments areas, and macro-
level for the entire nation. This report contains a discussion on three priority problems that
had been identified from the audit conducted in Victoria, and contain a comparison of the
catchment status with the national facts and figures, followed by discussion of strategies that
are in alignment with government policies.

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Table of Contents
Introduction................................................................................................................................3
Scale of the problem and determinants of health.......................................................................3
Social determinants of health.....................................................................................................4
Scale of the problem...................................................................................................................5
Impact of problem......................................................................................................................5
Governments’ priorities and targets...........................................................................................6
Assessing the financial cost of not addressing the problem.......................................................8
Potential to produce improvement.............................................................................................9
Conclusion..................................................................................................................................9
References................................................................................................................................11

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Introduction
Priority setting also encompasses several aspects of enhancing community health such
as, management or prevention of chronic disorders, primary care service, providing training
to specialists or community workers, identification of the population subgroups that should
be provided subsidized care, and formulating or enforcing multifaceted policy interventions
that commonly comprise of introduction of pay-for-performance arrangements for
compensating the healthcare providers (Collins et al. 2019). In other words, prioritisation is
essential owing to the fact that entitlements on healthcare resources are larger than those
available (Petricca et al. 2018). A health audit had been conducted in different subzones of
Victoria, the smallest mainland of Australia that facilitated collecting information on a range
of health indicators namely, age distribution, male-female ratio, indigenous population,
educational attainment, healthcare access, internet access, and physical health status. A
thorough analysis of the previously conducted assessment suggested that the major health
indicators that need to be addressed during priority setting were namely, less access of
females to healthcare service, poor educational attainment among females, and high
prevalence of obesity. This report will discuss the identified health indicators, in relation to
three articles and provide recommendations for the same.
Scale of the problem and determinants of health
Data comparison commonly refers to the usage of proportional epidemiological data,
with the aim of identifying the priority health requirements within a particular catchment.
Under circumstances when evidences provide confirmation for the fact that particular
catchment is subjected to inferior health status or shortcomings, in relation to benchmark in
further catchments, or national levels, the identified health issue becomes a matter of priority
(McDonald and Ollerenshaw 2011). Hence, making a comparison is indispensable for

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acknowledging the existing differences that in rural areas, with the metropolitan population.
The fact that females were found to have less access to healthcare services in Victoria in the
audit, was comparable to the fact that 12.4 million women experienced fluctuating health
outcomes in 2017, across different groups, including the elderly, indigenous, poor
socioeconomic groups, those who resided in remote areas. Furthermore, the findings of the
audit were completely different from the fact that in the nation, 240 million services had been
claimed by the females in 2017-18, with an average 19 Medicare services/female, thereby
suggesting that access to healthcare was particularly low amid females in Victoria, in contrast
to the entire nation (AIHW 2019). Thus, calling for the need of creating provisions that
would increase their access to these amenities, since access to high quality and
comprehensive healthcare is imperative for maintaining and promoting health, and reducing
premature death and accomplishing health equity.
Furthermore, the audit also suggested that there were high rates of obesity among
people aged 75 years or older. This is comparable to the fact that almost 2 in 3 Australian
adults had been identified as obese or overweight in 2014-15, and 28% of the entire national
population suffered from obesity in the same year, which was much more than 19%
prevalence in 1995 (ABS 2016). On the other hand, while the audit report suggested that
lesser number of females living in rural regions of Victoria could achieve high educational
attainment, it was in clear contrast to the national report where 90.1% females aged 20-24
completed Year 12 in 2015 and more females than males aged 18-24 years were able to attain
Certificate III or higher formal qualification during 2001-2015 (AIHW 2018).
Social determinants of health
Social determinants is an umbrella term that refers to the social and economic
condition that bring about group and individual variances in the health status of a population
(McDonald and Ollerenshaw 2011). Furthermore, the dissemination of social determinants is

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habitually governed by public plans that imitate the dominant political ideologies of the zone.
People who belong to the disadvantaged population have been found to manifest an increased
likelihood of experiencing poor health outcomes and reduced life expectancy (de Andrade et
al. 2015). Therefore, the priority setting needs to be directed to several upstream factors such
as, education, social support, food, social gradient, social exclusion, housing, employment,
and transport. Hence, it can be suggested that the aforementioned conditions create several
disadvantages for the females that prevents them from accessing educational and healthcare
services. In addition, socio-economic status, lack of awareness, absence of social support, and
increased access to junk and high calorie food have made the population more susceptible to
obesity.
Scale of the problem
The scale of a specific health problem denotes the number of individuals in a certain
catchment who are affected by the condition. The fundamental reason behind the incidence of
obesity can be accredited to an imbalance of energy between the consumed calories and those
expended (McDonald and Ollerenshaw 2011). This in turn occurs due to increased
consumption of foods that contain high fat content and due to adoption of a sedentary
lifestyle. Furthermore, lower social class in a community has also been associated with the
onset of multi-morbidity among the community residents (Piernas et al. 2016). Education is
imperative to economic and social development and creates intense influence on the
population health since high educational attainment increases access to resources, and also
helps in lowering the exposure of the population to chronic stress factors (Mirowsky 2017).
Impact of problem
Impacts of health problem are recognised using terms or measures such as, monetary
cost, quality of life, and social costs related to stigma allied with specific health

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complications, such as, obesity (Viergever et al. 2010). Obesity stigma has been identified as
a globalising health concern and it is well recognised that obese and overweight people who
are subjected to stigma commonly suffer from severe emotional suffering, and might also
have to endure socially-acceptable and legal discrimination, by modifying their dietary
patterns and exercise behaviors (Brewis, SturtzSreetharan and Wutich 2018). Furthermore,
low access to healthcare services also increase the rates of chronic disorders, thus elevating
rates of mortality and morbidity (Heiman and Artiga 2015). The impact of obesity is quite
high owing to the fact that an increased BMI acts as a major risk factor for the onset and
progress of several non-communicable diseases such as, cardiovascular complications,
musculoskeletal disorders, cancers, and diabetes mellitus (Thiese et al. 2015). Hence, the
aforementioned factors must be taken into consideration at the time of priority setting.
Governments’ priorities and targets
There are a plethora of methods that are typically used for priority setting namely, and
are classified into two groups namely, metrics based and consensus based approaches
(Viergever et al. 2010). While the former comprises of algorithm or metrics that pool the
individual rankings, the latter helps in leading priorities that need to be decided by consensus.
Efforts have been taken by the Council of Australian Governments (COAG) Health Council
(CHC) in 2018 to develop and implement a National Obesity Strategy, the primary aim of
which would be based on fostering collaboration between obesity experts to determine the
factor that are responsible for obesity and overweight (Obesity Policy Coalition 2018). In
addition, the government strategy also aims to recognise and develop a consensus on the
priority areas that need action, and also expects the stakeholders to share their experiences.
Further relation of the priority problem of obesity prevalence can be associated with the fact
that Select Committee into the Obesity Epidemic had been established in order to report on
prevalence rates of the condition, the cause for increased prevalence, health harms associated

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with the disease, economic burden, evidence-based medicine, and efficacy of pre-existing
policies (Parliament of Australia 2018).
Further alignment of the priority with government strategies encompass the presence
of Australian Dietary Guidelines, Health Food Partnership and the Physical Activity and
Sedentary Behaviour Guidelines that are available for providing updated advice on food
consumption, encouraging healthy eating, empowering food manufacturers, and guiding on
the intensity and duration of physical activity required to be performed, respectively
(Department of Health 2019). Besides the already existing policies, there is also a need to
promote education campaigns across all sub-zones of Victoria in order to increase awareness
among the target population of the health habits that predispose them to obesity, and the
lifestyle modifications that can be adopted to enhance health and wellbeing. This would also
be based on the principles of allocation for scare clinical interventions. Owing to the fact that
providing services to the sickest people forms a major aspect of priority setting, all efforts
need to be taken to ensure that the people belonging to the age group 75 years or older,
identified to be obese in Victoria will be subjected to necessary treatment modalities (Persad,
Wertheimer and Emanuel 2009). Apart from imparting patient education, the interventions
would also comprise of government policies that would make it necessary to take account of
obesity prognosis.
Taking into account the priority problem of reduced healthcare access amid women,
there are a range of policies in the nation that will prove effective in addressing the concern.
The Australian federal government outlines and resources Medicare welfares, which
commonly covers medical services, hospital care, and medicines, among others. In addition,
the government has also taken several efforts to provide free public hospital amenities to the
residents, including sponsorships and enticement payments related to chronic disease
prevention and management (Glover 2018). The Australian Commission on Safety and

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Quality in Health Care is also responsible for quality improvement and safety of healthcare
(ACSQHC 2018). Hence, the principal aim of addressing the priority of reduced healthcare
access among females would be to increase their awareness and knowledge on the basic
healthcare facilities and rights that they are entitled to, besides ensuring easy availability and
proximity of screening services, and primary healthcare facilities, regardless of the place of
residence.
The third priority problem of low educational attainment can be associated with the
fact that there the Australian Government has formulated and enforced the Australian
Education Act 2013, the primary aim of which is to deliver regular funding to
Australian schools, in order to ensure that they are able to deliver high quality education to all
students, notwithstanding of background, ethnicity or gender (Department of Education and
Training 2018). Furthermore, the National Early Childhood Development Strategy has also
been implemented by the government in order to develop educational attainment among
students, who belong to low socio-economic backgrounds (Commonwealth of Australia
2009). Therefore, while addressing this priority problem, the concept of youngest first should
be taken into consideration, where immediate strategies need to be adopted for allocating
educational resources to the young children, especially females, in order to help them attain
high educational levels in future (Persad, Wertheimer and Emanuel 2009).
Assessing the financial cost of not addressing the problem
Priority setting also comprises of making selections, thereby influencing the
accomplishment of positive outcomes, and lowering the cost of negative outcomes. Reports
from a modelling survey suggested that economic burden of obesity in 2011-12 was an
estimated $8.6 billion, which also comprised of $3.8 billion direct expenditure and $4.5
billion indirect expenditure. Furthermore, obesity and overweight accounted for roughly 7%
of the over-all health burden in the nation in 2011 (AIHW 2017).

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Potential to produce improvement
Priority setting in relation to increasing education and access to healthcare must strive
for suitable depiction of diverse expertise, and balanced regional and gender participation.
There is a need to eliminate chances of ‘pilotitis’ that commonly refers to dissatisfaction
among service providers and key stakeholders, related to lack of funding or geographical
limitations (McDonald and Ollerenshaw 2011). Further recommendations would also focus
on prognosis allocation that would be able to maximise the life expectancy of the population
by promoting equitable dissemination of resources. Due emphasis will also be placed on
social value allocation that will prioritise the stakeholders to enable the at-risk individuals for
health promotion (McDonald and Ollerenshaw 2011). Thorough and comprehensive
collection of technical data is imperative for informing argument on the identified priorities,
such as, the physical and economic burden of disease, intervention and strategy cost-
effectiveness, present resource flows, and the disease determinants.
Conclusion
Thus, it can be concluded that priority setting methods should be collaborative and
interdisciplinary. In the setting of health and social care systems, the concept of priority-
setting is associated with appropriate allocation of capitals to implementation of inventive
high-cost drugs or novel vaccines and their accurate introduction to the public health system.
In reality, the domain of priority setting is multifaceted and value-laden, and typically
comprises of trade-offs between challenging intentions, and should take into consideration
the constraint on resources, and is often distorted by government strategies. On conducting an
audit in Victoria, the three major priorities that were identified were obesity prevalence, low
female educational attainment, and poor access to healthcare services among the females.
Thus, the aforementioned findings drew a comparison of the audit data with national

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statistics, and also identified the existing government strategies, which if implemented
accurately, might facilitate elimination of the priority problems.

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