always, accountability has been a key concept in public administration; but accountability in street-level bureaucracies where people have a daily contact with bureaucrats is of particular importance. the police are among these organizations which their accountability plays a pivotal role in obtaining public trust. the purpose of this study, which was carried out in the police stations of the s...

BACKGROUND In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania. The objective of this paper is to explore the acceptability of Accountability for Reasonablene...

BACKGROUND Priority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease (BOD) and cost-effectiveness analysis (CEA), which is helpful, but insufficient because it focuses on a narrow range of values - need and efficiency - and not the full range of relevant values, including legitimacy and fairne...

BACKGROUND Priority setting, also known as rationing or resource allocation, occurs at all levels of every health care system. Daniels and Sabin have proposed a framework for priority setting in health care institutions called 'accountability for reasonableness', which links priority setting to theories of democratic deliberation. Fairness is a key goal of priority setting. According to 'accoun...

Health care systems are faced with the challenge of resource scarcity and have insufficient resources to respond to all health problems and target groups simultaneously. Hence, priority setting is an inevitable aspect of every health system. However, priority setting is complex and difficult because the process is frequently influenced by political, institutional and managerial factors that are...

Fairness is a key goal of priority setting and ‘accountability for reasonableness’ has emerged as the leading framework for fair priority setting. However, it has not been shown acceptable to those engaged in priority setting. In particular, since it was developed in the context of a primarily privately funded health system, its applicability in a primarily publicly funded system is uncertain. ...

Governments can be accountable for improving the fairness of their priority setting through enhanced transparency and stakeholder engagement. A case analysis is conducted of priority setting in a government health care context in Ontario, Canada, assessing how implementation of hospital accountability agreements meets the conditions of a leading international ethical framework for priority sett...

BACKGROUND Priority setting is one of the most difficult issues facing hospitals because of funding restrictions and changing patient need. A deadly communicable disease outbreak, such as the Severe Acute Respiratory Syndrome (SARS) in Toronto in 2003, amplifies the difficulties of hospital priority setting. The purpose of this study is to describe and evaluate priority setting in a hospital in...

OBJECTIVE To describe priority setting for admissions in a hospital critical care unit and to evaluate it using the ethical framework of "accountability for reasonableness. DESIGN Qualitative case study and evaluation using the ethical framework of accountability for reasonableness. SETTING A medical/surgical intensive care unit in a large urban university-affiliated teaching hospital in To...

Priority setting tends to take place in health care settings that are hierarchical and politically complex. Fair processes, as defined for example by Daniels' and Sabin's accountability for reasonableness framework, have been identified as essential for securing socially acceptable priority setting decisions. However, power differences in the decision-making context can pose a serious impedimen...