| This study is entitled "The Determinants of Stakeholder Preferences for Health Resource Allocation". It addresses the research question "What are the effects of selected demographic, economic, political, historical, and psychosocial background factors on the health resource allocation preferences expressed by professional, managerial, governance, client, private and public health stakeholder groups in the Calgary Health Region 2005? The general purpose of the research is to generate knowledge about the factors that might influence an individual's resource allocation decisions about health care.;The study employs a mixed exploratory-modeling design. It is descriptive and exploratory in that real world conditions and variables are not manipulated, but observed and recorded. There is an openess to one, none, some, or all theoretical hypotheses as plausible and potentially supported. The modeling methodology is structural equation modeling, a confirmatory methodology in that preliminary hypotheses are tested, refined and retested for validation by the data.;Random samples of ten key health stakeholder groups in Calgary, comprise the study sample. In total, 1000 stakeholders are surveyed with the intent to achieve subgroups of 30-50 people. These stakeholder groups are presumed to directly participate or indirectly exert influence in the resource allocation decision process in health care. It is a limitation of the study that all possible stakeholder groups e.g. politicians and government bureaucrats, and other influential variables known and unknown, cannot be included.;A mail survey is the main mechanism for data collection; the instrument is especially developed for this study. Forty survey items are taken from past Health Canada and Alberta Health surveys. These yield 80 core variables and 380 sub-variables. Statistical analyses include descriptive statistics, correlations, chi-square, multiple regression, and structural equation modeling. Results are theoretically limited to the Calgary health region, but may be insightful for other public programs and jurisdictions. Findings include nine detailed stakeholder preference profiles. The overall response rate is 26.5%, with stakeholder subgroups ranging from 13.5% (patients and family members) to 59% (nurses). Twenty-three theoretical hypotheses are examined and several statistically significant Pearson Correlations, ANOVA, and t-tests documented. 218 structural equation models are investigated but none are found statistically significant. Possible reasons for this are discussed.;Research into the determinants of stakeholder preferences for health resource allocation is an underdeveloped area in both management and health research. As such, there are no theories directly applicable to the question. Twenty-three preliminary a priori hypotheses are generated based on six established theories that appear plausible and important to this topic. They are tested for validity, compared on the basis of statistical strength, and revised or replaced as indicated.;The significance of this research lies in the potential to compare multiple stakeholder groups, using multiple theoretical lenses, for exploring the possible determinants of health resource allocation preferences. Since none of the hypotheses are supported by the analysis, a new approach should be attempted in future research.;This is original research that is pertinent to current issues and dilemmas in health care management. As expected, this study contributes most to the developing knowledge base about stakeholders and stakeholder theory, which informs sectors including and beyond health care and public service administration. At a practical level it informs and assists health care decision-makers who struggle with the political challenges of constrained resources and multiple service priorities. |
