Priority setting meets multiple streams: A match to be further examined?: Comment on “Introducing new priority setting and resource allocation processes in a Canadian healthcare organization: A case study analysis informed by multiple streams theory”

© 2016 by Kerman University of Medical Sciences. With demand for health services continuing to grow as populations age and new technologies emerge to meet health needs, healthcare policy-makers are under constant pressure to set priorities, ie, to make choices about the health services that can and cannot be funded within available resources. In a recent paper, Smith et al apply an influential policy studies framework - Kingdon’s multiple streams approach (MSA) - to explore the factors that explain why one health service delivery organization adopted a formal priority setting framework (in the form of programme budgeting and marginal analysis [PBMA]) to assist it in making priority setting decisions. MSA is a theory of agenda-setting, ie, how it is that different issues do or do not reach a decision-making point. In this paper, I reflect on the use of the MSA framework to explore priority setting processes and how the framework might be applied to similar cases in future.