Marginal analysis in practice

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6966.1438b (Published 26 November 1994) Cite this as: BMJ 1994;309:1438
  1. Alan Mordue,
  2. Neil Craig
  1. Consultant in public health medicine, Department of Public Health, Borders Health Board, Melrose, Roxburghshire TD6 9BP
  2. Health economist, Department of Public Health, Newcastle and North Tyneside Health Authority, Newcastle upon Tyne NE2 1EF.

    EDITOR,—We congratulate David Cohen on two counts: firstly, on achieving formal acceptance of a framework for assessing purchasing priorities and seeing this through to changes in contracts; and, secondly, on achieving a disinvestment list of 10 areas.1 Many purchasing authorities seem to have no framework (some even seem unaware that they need one), and clinicians can be reluctant to consider disinvestments.2

    Cohen emphasises that the composition of the working group in the first stage needs careful consideration because the process is value laden. Despite this he gives no explanation …

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