The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
The Fund identifies and shares policy ideas and analysis to advance state health leadership, strong primary care, and sustainable health care costs.
Keep up with news and updates from the Milbank Memorial Fund. And read the latest blogs from our thought leaders, including Fund President Christopher F. Koller.
The Fund publishes The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to health policy leaders.
The Milbank Memorial Fund is is a foundation that works to improve population health and health equity.
March 2016 (Volume 94)
Quarterly Article
Charles Phelps
Guruprasad Madhavan
Rino Rappuoli
Scott Levin
Edward Shortliffe
Rita Colwell
Nov 5, 2024
Oct 30, 2024
Oct 23, 2024
Back to The Milbank Quarterly
Policy Points:
Context: Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost-effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions.
Methods: Our work employed a multicriteria systems analysis approach—specifically, multiattribute utility theory—to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost-effectiveness analysis approach.
Findings: (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost-effectiveness analysis. (2) More sophisticated systems-level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become scarcer.
Conclusions: The teaching of strategic planning in public health must be expanded in order to fill a void in the profession’s planning capabilities. Public health training should actively incorporate model building, promote the interactive use of software tools, and explore planning approaches that transcend restrictive assumptions of cost-effectiveness analysis. The Strategic Multi- Attribute Ranking Tool for Vaccines (SMART Vaccines), which was recently developed by the Institute of Medicine and the National Academy of Engineering to help prioritize new vaccine development, is a working example of systems analysis as a basis for decision support.
Author(s): Charles Phelps, Guruprasad Madhavan, Rino Rappuoli, Scott Levin, Edward Shortliffe, and Rita Colwell
Keywords: systems analysis, population health, public health practice, cost-effectiveness
Read on Wiley Online Library
Volume 94, Issue 1 (pages 109–125) DOI: 10.1111/1468-0009.12182 Published in 2016
