Arvidsson, E., André, M., Borgquist, L., & Carlsson, P. (2010). Priority Setting in Primary Health Care – Dilemmas and Opportunities: A Focus Group Study. BMC Family Practice, 11(71). Retrieved from: http://www.biomedcentral.com/1471-2296/11/71.

Swedish health care authorities use three key criteria to produce national guidelines for local priority setting: severity of the health condition; expected patient benefit; and cost-effectiveness of medical intervention. The objective of the study was to qualitatively assess how general practitioners (GPs) and nurses perceive the application of the three key priority-setting criteria.

Priority setting in primary health care (PHC) has significant implications for health costs and outcomes in the health care system. Nevertheless, these guidelines have been implemented to a very limited degree in PHC.

Methods
Focus groups were held with GPs and nurses at primary health care centres, where the staff had a short period of experience in using the criteria for prioritising in their daily work.

Results
The staff found the three key priority-setting criteria (severity, patient benefit, and cost-effectiveness) to be valuable for priority setting in PHC. However, when the criteria were applied in PHC, three additional dimensions were identified: 1) viewpoint (medical or patient’s), 2) timeframe (now or later), and 3) evidence level (group or individual).

Conclusions
The three key priority-setting criteria were useful. Considering the three additional dimensions might enhance implementation of national guidelines in PHC and is probably a prerequisite for the criteria to be useful in priority setting for individual patients.